Healthcare Provider Details
I. General information
NPI: 1487586210
Provider Name (Legal Business Name): MARA PUGLISI CHHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 06/03/2026
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
19 HIDDEN VALLEY DR
NEWARK DE
19711-7463
US
IV. Provider business mailing address
19 HIDDEN VALLEY DR
NEWARK DE
19711-7463
US
V. Phone/Fax
- Phone: 240-338-0137
- Fax:
- Phone: 240-338-0137
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 171400000X |
| Taxonomy | Health & Wellness Coach |
| License Number | |
| License Number State | DE |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: