Provider Demographics
NPI:1144967951
Name:HUGO, ROGENA GHALY (MA, LADC)
Entity type:Individual
Prefix:
First Name:ROGENA
Middle Name:GHALY
Last Name:HUGO
Suffix:
Gender:F
Credentials:MA, LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:165 GOLFVIEW DR
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03102-8926
Mailing Address - Country:US
Mailing Address - Phone:508-505-7800
Mailing Address - Fax:
Practice Address - Street 1:165 GOLFVIEW DR
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03102-8926
Practice Address - Country:US
Practice Address - Phone:508-505-7800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-14
Last Update Date:2022-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1211101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)