Healthcare Provider Details

I. General information

NPI: 1346284080
Provider Name (Legal Business Name): VICKI ANN KUGLER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/15/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

628 E WILLAMETTE AVE
COLORADO SPRINGS CO
80903-3031
US

IV. Provider business mailing address

628 E WILLAMETTE AVE
COLORADO SPRINGS CO
80903-3031
US

V. Phone/Fax

Practice location:
  • Phone: 719-471-7442
  • Fax: 719-471-7442
Mailing address:
  • Phone: 719-471-7442
  • Fax: 719-471-7442

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number991852
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: