Provider Demographics
NPI:1366825028
Name:HUGHES, CARMEN DENAY
Entity type:Individual
Prefix:
First Name:CARMEN
Middle Name:DENAY
Last Name:HUGHES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CARMEN
Other - Middle Name:DENAY
Other - Last Name:HUGHES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCOTA
Mailing Address - Street 1:791 NEW ZION RD
Mailing Address - Street 2:
Mailing Address - City:WINNSBORO
Mailing Address - State:LA
Mailing Address - Zip Code:71295-5731
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:791 NEW ZION RD
Practice Address - Street 2:
Practice Address - City:WINNSBORO
Practice Address - State:LA
Practice Address - Zip Code:71295-5731
Practice Address - Country:US
Practice Address - Phone:979-997-6581
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-30
Last Update Date:2015-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAZ20532224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant