Provider Demographics
NPI:1982046223
Name:HUGHES, ALISSA GAIL
Entity Type:Individual
Prefix:
First Name:ALISSA
Middle Name:GAIL
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 1:9780 LANTERN RD STE 350
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46037-4093
Mailing Address - Country:US
Mailing Address - Phone:317-800-6200
Mailing Address - Fax:
Practice Address - Street 1:9780 LANTERN RD STE 350
Practice Address - Street 2:
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46037-4093
Practice Address - Country:US
Practice Address - Phone:317-800-6200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-29
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN46002474A235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist