| Doctor Name: | DR. KENDRA LYNN PUGH |
| NPI Number: | 1235363037 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PSY. D |
| License Number: | 0810001789 |
| Business Practice Address: | 107 W Ellerslie Ave Colonial Heights, VA - 238341513 |
| Business Phone Number: | 8045201655 |
| Business Fax Number: | 8045208595 |
| Mailing Address: | Po Box 579, COLONIAL HEIGHTS |
| State: | VA |
| Postal Code: | 238340579 |
| Phone Number: | 8045201655 |
| Fax Number: | 8045208595 |
| NPI Enumeration Date: | 05/07/2009 |
| NPI Last Update Date: | 06/04/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 0810001789 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |