Basic Information
Provider Information
NPI: 1801414339
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PUGIA
FirstName: ALEIS
MiddleName:  
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Credential:  
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Mailing Information
Address1: 2255 S ONEIDA ST
Address2:  
City: DENVER
State: CO
PostalCode: 802242522
CountryCode: US
TelephoneNumber: 3037611977
FaxNumber:  
Practice Location
Address1: 3292 PEORIA ST
Address2:  
City: AURORA
State: CO
PostalCode: 800101517
CountryCode: US
TelephoneNumber: 3033606276
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/10/2020
LastUpdateDate: 10/26/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
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AuthorizedOfficialCredential:  
NPICertificationDate: 10/26/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
103T00000XPSY.0005907COY Behavioral Health & Social Service ProvidersPsychologist 

No ID Information.


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