Individual
MS. KRISTIE L BUGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS LCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1086-123
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1016362
PREFERREDONE PIN
WI
01
—
18935
MMSI PROVIDER NUMBER
MN
01
—
37495
SECURITY HEALTH PLAN ID
WI
05
—
39239400
—
WI
Enumeration date
05/22/2006
Last updated
07/09/2007
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