Provider Demographics
NPI:1356118335
Name:HUGHES, MIRANDA (OTR/L)
Entity type:Individual
Prefix:
First Name:MIRANDA
Middle Name:
Last Name:HUGHES
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7045 E RIVER RD
Mailing Address - Street 2:
Mailing Address - City:RUSH
Mailing Address - State:NY
Mailing Address - Zip Code:14543-9787
Mailing Address - Country:US
Mailing Address - Phone:585-831-7277
Mailing Address - Fax:
Practice Address - Street 1:7045 E RIVER RD
Practice Address - Street 2:
Practice Address - City:RUSH
Practice Address - State:NY
Practice Address - Zip Code:14543-9787
Practice Address - Country:US
Practice Address - Phone:585-831-7277
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-08
Last Update Date:2023-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA25457225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation