Provider Demographics
NPI:1831355411
Name:HUGHES, JOAN MARIE (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:JOAN
Middle Name:MARIE
Last Name:HUGHES
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11644 S 102ND EAST AVE
Mailing Address - Street 2:
Mailing Address - City:BIXBY
Mailing Address - State:OK
Mailing Address - Zip Code:74008-3006
Mailing Address - Country:US
Mailing Address - Phone:918-638-9673
Mailing Address - Fax:918-970-2951
Practice Address - Street 1:11644 S 102ND EAST AVE
Practice Address - Street 2:
Practice Address - City:BIXBY
Practice Address - State:OK
Practice Address - Zip Code:74008-3006
Practice Address - Country:US
Practice Address - Phone:918-638-9673
Practice Address - Fax:918-970-2951
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-01
Last Update Date:2012-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3418235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist