Provider Demographics
NPI:1104054329
Name:HUGHES, JAMI JEYN (PSYD, BCBA-D)
Entity type:Individual
Prefix:DR
First Name:JAMI
Middle Name:JEYN
Last Name:HUGHES
Suffix:
Gender:F
Credentials:PSYD, BCBA-D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 W TRAVELERS TRL STE 212
Mailing Address - Street 2:
Mailing Address - City:BURNSVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55337-4905
Mailing Address - Country:US
Mailing Address - Phone:651-295-7440
Mailing Address - Fax:612-437-4499
Practice Address - Street 1:201 W TRAVELERS TRL STE 212
Practice Address - Street 2:
Practice Address - City:BURNSVILLE
Practice Address - State:MN
Practice Address - Zip Code:55337-4905
Practice Address - Country:US
Practice Address - Phone:651-295-7440
Practice Address - Fax:612-437-4499
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-25
Last Update Date:2020-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5121103T00000X
FL1-12-12557103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN0BI29HUOtherBCBS-MN