Provider Demographics
NPI:1427300292
Name:PUGLIA, ANGELA C (LCSW)
Entity type:Individual
Prefix:MISS
First Name:ANGELA
Middle Name:C
Last Name:PUGLIA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 RUFIN PL
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON
Mailing Address - State:LA
Mailing Address - Zip Code:70121-1321
Mailing Address - Country:US
Mailing Address - Phone:504-813-2009
Mailing Address - Fax:
Practice Address - Street 1:12 RUFIN PL
Practice Address - Street 2:
Practice Address - City:JEFFERSON
Practice Address - State:LA
Practice Address - Zip Code:70121-1321
Practice Address - Country:US
Practice Address - Phone:504-813-2009
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-03
Last Update Date:2012-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA85431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical