Provider Demographics
NPI:1134514169
Name:HUGHES THERAPY 1
Entity Type:Organization
Organization Name:HUGHES THERAPY 1
Other - Org Name:COVENANT SEX THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:HUGHES
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:385-312-9844
Mailing Address - Street 1:3355 N UNIVERSITY AVE STE 250
Mailing Address - Street 2:
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84604-6640
Mailing Address - Country:US
Mailing Address - Phone:385-312-9844
Mailing Address - Fax:
Practice Address - Street 1:3355 N UNIVERSITY AVE STE 250
Practice Address - Street 2:
Practice Address - City:PROVO
Practice Address - State:UT
Practice Address - Zip Code:84604-6640
Practice Address - Country:US
Practice Address - Phone:385-312-9844
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-06
Last Update Date:2015-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT356326-3902251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health