Basic Information
| Provider Information | |||||||||
| NPI: | 1417578261 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PAGLIUGHI | ||||||||
| FirstName: | KASSIE | ||||||||
| MiddleName: | L | ||||||||
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| Mailing Information | |||||||||
| Address1: | 405 N ERIE ST APT 1 | ||||||||
| Address2: | |||||||||
| City: | BAY CITY | ||||||||
| State: | MI | ||||||||
| PostalCode: | 487064489 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9897781396 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1100 N. GRANT STREET | ||||||||
| Address2: | |||||||||
| City: | BAY CITY | ||||||||
| State: | MI | ||||||||
| PostalCode: | 48708 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9897781396 | ||||||||
| FaxNumber: | 9897781394 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/04/2020 | ||||||||
| LastUpdateDate: | 05/04/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 05/04/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | Y | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) |
No ID Information.