Provider Demographics
NPI:1750803771
Name:HUGHES, STEPHANIE (PHD, CCC-SLP)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:HUGHES
Suffix:
Gender:F
Credentials:PHD, 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:PO BOX 386
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:MI
Mailing Address - Zip Code:48611-0386
Mailing Address - Country:US
Mailing Address - Phone:989-450-9359
Mailing Address - Fax:
Practice Address - Street 1:4653 GARFIELD RD
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:MI
Practice Address - Zip Code:48611-9437
Practice Address - Country:US
Practice Address - Phone:989-450-9359
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-11
Last Update Date:2017-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7101005077235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist