Provider Demographics
NPI:1710539549
Name:KUGZRUK, MARGARET LOUISE (LMSW)
Entity Type:Individual
Prefix:MS
First Name:MARGARET
Middle Name:LOUISE
Last Name:KUGZRUK
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:650 YOUNKER CT
Mailing Address - Street 2:
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99701-7586
Mailing Address - Country:US
Mailing Address - Phone:907-456-1053
Mailing Address - Fax:907-456-2114
Practice Address - Street 1:650 YOUNKER CT
Practice Address - Street 2:
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99701-7586
Practice Address - Country:US
Practice Address - Phone:907-456-1053
Practice Address - Fax:907-456-2114
Is Sole Proprietor?:No
Enumeration Date:2019-07-11
Last Update Date:2019-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
AK1044831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical