Provider Demographics
NPI:1689438814
Name:HUGAR, DIANE
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:
Last Name:HUGAR
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 1:516 E KENTUCKY AVE
Mailing Address - Street 2:
Mailing Address - City:ANADARKO
Mailing Address - State:OK
Mailing Address - Zip Code:73005-4237
Mailing Address - Country:US
Mailing Address - Phone:405-638-2574
Mailing Address - Fax:
Practice Address - Street 1:516 E KENTUCKY AVE
Practice Address - Street 2:
Practice Address - City:ANADARKO
Practice Address - State:OK
Practice Address - Zip Code:73005-4237
Practice Address - Country:US
Practice Address - Phone:405-638-2574
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-08
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach