Provider Demographics
NPI:1548537301
Name:HUGHES, BRENNA LEA (MA, CCC-SLP)
Entity type:Individual
Prefix:
First Name:BRENNA
Middle Name:LEA
Last Name:HUGHES
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1426 N KAWEAH AVE
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93619-8067
Mailing Address - Country:US
Mailing Address - Phone:559-321-4266
Mailing Address - Fax:559-961-3535
Practice Address - Street 1:1426 N KAWEAH AVE
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93619-8067
Practice Address - Country:US
Practice Address - Phone:559-321-4266
Practice Address - Fax:559-961-3535
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-22
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16332235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist