Provider Demographics
NPI:1275147019
Name:HUGHES, LIBBY RAE
Entity Type:Individual
Prefix:
First Name:LIBBY
Middle Name:RAE
Last Name:HUGHES
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 1:1170 S FOOTHILL DR APT 323
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84108-1955
Mailing Address - Country:US
Mailing Address - Phone:503-575-0408
Mailing Address - Fax:
Practice Address - Street 1:1170 S FOOTHILL DR APT 323
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84108-1955
Practice Address - Country:US
Practice Address - Phone:503-575-0408
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-31
Last Update Date:2020-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical