Provider Demographics
NPI:1437497971
Name:HUGHES, WANDA RAYE (MA , CCC-SLP)
Entity Type:Individual
Prefix:
First Name:WANDA
Middle Name:RAYE
Last Name:HUGHES
Suffix:
Gender:F
Credentials:MA , CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 563
Mailing Address - Street 2:
Mailing Address - City:HEMINGWAY
Mailing Address - State:SC
Mailing Address - Zip Code:29554-0563
Mailing Address - Country:US
Mailing Address - Phone:843-933-2531
Mailing Address - Fax:
Practice Address - Street 1:160 E MARION ST
Practice Address - Street 2:
Practice Address - City:JOHNSONVILLE
Practice Address - State:SC
Practice Address - Zip Code:29555-6517
Practice Address - Country:US
Practice Address - Phone:843-386-2955
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-17
Last Update Date:2013-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3395235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist