Provider Demographics
NPI:1831620517
Name:HUGHES, WALTER (MS)
Entity type:Individual
Prefix:
First Name:WALTER
Middle Name:
Last Name:HUGHES
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2298 CHANCERY MILL LN
Mailing Address - Street 2:
Mailing Address - City:BUFORD
Mailing Address - State:GA
Mailing Address - Zip Code:30519-4678
Mailing Address - Country:US
Mailing Address - Phone:678-699-6972
Mailing Address - Fax:
Practice Address - Street 1:2298 CHANCERY MILL LN
Practice Address - Street 2:
Practice Address - City:BUFORD
Practice Address - State:GA
Practice Address - Zip Code:30519-4678
Practice Address - Country:US
Practice Address - Phone:678-699-6972
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-23
Last Update Date:2017-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health