Provider Demographics
NPI:1093262602
Name:HUGHES, TAMELA MICHELLE (BSW, MHP)
Entity Type:Individual
Prefix:
First Name:TAMELA
Middle Name:MICHELLE
Last Name:HUGHES
Suffix:
Gender:F
Credentials:BSW, MHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1404 WASHINGTON AVE.
Mailing Address - Street 2:
Mailing Address - City:CAIRO
Mailing Address - State:IL
Mailing Address - Zip Code:62914
Mailing Address - Country:US
Mailing Address - Phone:618-734-2665
Mailing Address - Fax:
Practice Address - Street 1:1404 WASHINGTON AVE.
Practice Address - Street 2:
Practice Address - City:CAIRO
Practice Address - State:IL
Practice Address - Zip Code:62914
Practice Address - Country:US
Practice Address - Phone:618-734-2665
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-01
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health