Provider Demographics
NPI:1821130048
Name:DUGAN, KENNETH G (PHD)
Entity Type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:G
Last Name:DUGAN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1369 OLD YORK RD
Mailing Address - Street 2:
Mailing Address - City:ABINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:19001-3411
Mailing Address - Country:US
Mailing Address - Phone:215-884-1776
Mailing Address - Fax:215-884-0171
Practice Address - Street 1:1369 OLD YORK RD
Practice Address - Street 2:
Practice Address - City:ABINGTON
Practice Address - State:PA
Practice Address - Zip Code:19001-3411
Practice Address - Country:US
Practice Address - Phone:215-884-1776
Practice Address - Fax:215-884-0171
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS008488L101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health