Provider Demographics
NPI:1225586381
Name:HUFTY, MARTHA
Entity Type:Individual
Prefix:MRS
First Name:MARTHA
Middle Name:
Last Name:HUFTY
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 1:3508 S LAPEER RD
Mailing Address - Street 2:
Mailing Address - City:METAMORA
Mailing Address - State:MI
Mailing Address - Zip Code:48455-8768
Mailing Address - Country:US
Mailing Address - Phone:810-212-1134
Mailing Address - Fax:810-212-1135
Practice Address - Street 1:3508 S LAPEER RD
Practice Address - Street 2:
Practice Address - City:METAMORA
Practice Address - State:MI
Practice Address - Zip Code:48455-8768
Practice Address - Country:US
Practice Address - Phone:810-212-1134
Practice Address - Fax:810-212-1135
Is Sole Proprietor?:No
Enumeration Date:2016-09-19
Last Update Date:2016-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7101004339235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist