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NPI Code Detail

MEDICARE: BOBBI TUGGLE BCBA, LBA

MEDICARE: BOBBI TUGGLE BCBA, LBA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst267023KY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11356843650OTHERKYNPI

General Provider Information

NPI Number : 1356843650
Entity Type Code : Individual
Provider Name (Legal Business Name) : BOBBI TUGGLE BCBA, LBA
Provider Business Mailing Address
First Line : 2100 LIBERTY RD
Second Line :
City : LEXINGTON
State : KY
Zip : 40509-4319
Country : US
Telephone Number : 859-447-2309
Fax Number : 502-808-6024
Provider Business Practice Location Address
First Line : 2100 LIBERTY RD
Second Line :
City : LEXINGTON
State : KY
Zip : 40509-4319
Country : US
Telephone Number : 502-777-2397
Fax Number : 502-808-6024
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/02/2018
Last Update Date : 12/29/2022

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