Provider Demographics
NPI:1437799301
Name:HUGHES, LAUREN
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:
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 1:4736 SARDIS RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT OLIVET
Mailing Address - State:KY
Mailing Address - Zip Code:41064-7636
Mailing Address - Country:US
Mailing Address - Phone:606-842-0181
Mailing Address - Fax:
Practice Address - Street 1:4736 SARDIS RD
Practice Address - Street 2:
Practice Address - City:MOUNT OLIVET
Practice Address - State:KY
Practice Address - Zip Code:41064-7636
Practice Address - Country:US
Practice Address - Phone:606-842-0181
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-08
Last Update Date:2020-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYW94-068-976OtherDRIVER'S LICENSE