Provider Demographics
NPI:1316120512
Name:HUGHES, KATHY KELLEY (SLP)
Entity type:Individual
Prefix:
First Name:KATHY
Middle Name:KELLEY
Last Name:HUGHES
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4670 HIGHWAY 80
Mailing Address - Street 2:
Mailing Address - City:HAUGHTON
Mailing Address - State:LA
Mailing Address - Zip Code:71037-9418
Mailing Address - Country:US
Mailing Address - Phone:318-272-4711
Mailing Address - Fax:
Practice Address - Street 1:4670 HIGHWAY 80
Practice Address - Street 2:
Practice Address - City:HAUGHTON
Practice Address - State:LA
Practice Address - Zip Code:71037-9418
Practice Address - Country:US
Practice Address - Phone:318-272-4711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-11
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX01076820235Z00000X
MS50808235Z00000X
NC4556235Z00000X
LA5307235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist