Provider Demographics
NPI:1912137373
Name:HUGHETT, HEIDI MARIE (MAOM, LIC AC)
Entity type:Individual
Prefix:
First Name:HEIDI
Middle Name:MARIE
Last Name:HUGHETT
Suffix:
Gender:F
Credentials:MAOM, LIC AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:191 S MAIN ST
Mailing Address - Street 2:SUITE 107
Mailing Address - City:MIDDLETON
Mailing Address - State:MA
Mailing Address - Zip Code:01949-2514
Mailing Address - Country:US
Mailing Address - Phone:978-777-2707
Mailing Address - Fax:
Practice Address - Street 1:191 S MAIN ST
Practice Address - Street 2:SUITE 107
Practice Address - City:MIDDLETON
Practice Address - State:MA
Practice Address - Zip Code:01949-2514
Practice Address - Country:US
Practice Address - Phone:978-777-2707
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-20
Last Update Date:2011-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist