Provider Demographics
NPI:1679779938
Name:HUGHES, KELLY J (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:J
Last Name:HUGHES
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 ARBOR ST
Mailing Address - Street 2:#2
Mailing Address - City:EXETER
Mailing Address - State:NH
Mailing Address - Zip Code:03833-2634
Mailing Address - Country:US
Mailing Address - Phone:617-460-6326
Mailing Address - Fax:
Practice Address - Street 1:442 MAIN ST
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:NH
Practice Address - Zip Code:03044-3434
Practice Address - Country:US
Practice Address - Phone:603-895-3126
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0683235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist