Provider Demographics
NPI:1730654765
Name:HUGHES, RONNESHA S
Entity Type:Individual
Prefix:
First Name:RONNESHA
Middle Name:S
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 1:4898 VALLEYDALE RD STE B2
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35242-4661
Mailing Address - Country:US
Mailing Address - Phone:205-795-3410
Mailing Address - Fax:
Practice Address - Street 1:4898 VALLEYDALE RD STE B2
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35242-4661
Practice Address - Country:US
Practice Address - Phone:205-795-3410
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-05
Last Update Date:2018-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALC2874A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL$$$$$$$$$Medicaid