Provider Demographics
NPI:1972095685
Name:HUGHES, JACQUELINE DEETS (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:DEETS
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 1:23 ROYAL RD STE 203
Mailing Address - Street 2:
Mailing Address - City:FLEMINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08822-6001
Mailing Address - Country:US
Mailing Address - Phone:609-238-3474
Mailing Address - Fax:
Practice Address - Street 1:23 ROYAL RD STE 203
Practice Address - Street 2:
Practice Address - City:FLEMINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08822-6001
Practice Address - Country:US
Practice Address - Phone:609-238-3474
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-30
Last Update Date:2018-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00060500235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist