Provider Demographics
NPI:1598505109
Name:PACKLER, SUGEY ARLETTE
Entity type:Individual
Prefix:
First Name:SUGEY
Middle Name:ARLETTE
Last Name:PACKLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:918 GATEWAY COMMONS CIR
Mailing Address - Street 2:
Mailing Address - City:WAKE FOREST
Mailing Address - State:NC
Mailing Address - Zip Code:27587-5992
Mailing Address - Country:US
Mailing Address - Phone:786-604-7080
Mailing Address - Fax:
Practice Address - Street 1:918 GATEWAY COMMONS CIR
Practice Address - Street 2:
Practice Address - City:WAKE FOREST
Practice Address - State:NC
Practice Address - Zip Code:27587-5992
Practice Address - Country:US
Practice Address - Phone:786-604-7080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-30
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC21546225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist