Provider Demographics
NPI:1427746221
Name:HUGHES, DEZIRAY A
Entity type:Individual
Prefix:
First Name:DEZIRAY
Middle Name:A
Last Name:HUGHES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:916 HOLGATE CT
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37221-6630
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5600 BRYANT HOLLOW RD
Practice Address - Street 2:
Practice Address - City:CUNNINGHAM
Practice Address - State:TN
Practice Address - Zip Code:37052-4729
Practice Address - Country:US
Practice Address - Phone:931-218-8651
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-28
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst