Provider Demographics
NPI:1588828610
Name:MUGGLI, TINA MARIE (MA, LMFT)
Entity Type:Individual
Prefix:
First Name:TINA
Middle Name:MARIE
Last Name:MUGGLI
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:228 VANDERBILT DR
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33460-6241
Mailing Address - Country:US
Mailing Address - Phone:507-412-9006
Mailing Address - Fax:507-934-2654
Practice Address - Street 1:228 VANDERBILT DR
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33460-6241
Practice Address - Country:US
Practice Address - Phone:507-412-9006
Practice Address - Fax:507-934-2654
Is Sole Proprietor?:No
Enumeration Date:2008-07-17
Last Update Date:2022-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1903106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist