Provider Demographics
NPI:1447508148
Name:HUGHART, HEIDI D
Entity type:Individual
Prefix:MRS
First Name:HEIDI
Middle Name:D
Last Name:HUGHART
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 1:365 E MAIN ST
Mailing Address - Street 2:SUITE 5
Mailing Address - City:BRANFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06405-2913
Mailing Address - Country:US
Mailing Address - Phone:203-415-8495
Mailing Address - Fax:
Practice Address - Street 1:365 E MAIN ST
Practice Address - Street 2:SUITE 5
Practice Address - City:BRANFORD
Practice Address - State:CT
Practice Address - Zip Code:06405-2913
Practice Address - Country:US
Practice Address - Phone:203-415-8495
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-28
Last Update Date:2015-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health