Provider Demographics
NPI:1013969070
Name:HUGHES, CAROLYN BRUNETTO (DPT, CLT)
Entity Type:Individual
Prefix:MRS
First Name:CAROLYN
Middle Name:BRUNETTO
Last Name:HUGHES
Suffix:
Gender:F
Credentials:DPT, CLT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 SEVERN AVE
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21403-2610
Mailing Address - Country:US
Mailing Address - Phone:410-703-4307
Mailing Address - Fax:
Practice Address - Street 1:132 HOLIDAY CT
Practice Address - Street 2:SUITE 203
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-7005
Practice Address - Country:US
Practice Address - Phone:410-573-9930
Practice Address - Fax:410-573-9932
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD21563174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist