Provider Demographics
NPI:1609672872
Name:HUGHES, HEIDI LYNN (LMT)
Entity type:Individual
Prefix:MS
First Name:HEIDI
Middle Name:LYNN
Last Name:HUGHES
Suffix:
Gender:
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 685
Mailing Address - Street 2:
Mailing Address - City:GALES FERRY
Mailing Address - State:CT
Mailing Address - Zip Code:06335-0685
Mailing Address - Country:US
Mailing Address - Phone:757-351-9224
Mailing Address - Fax:
Practice Address - Street 1:391 LONG HILL RD
Practice Address - Street 2:
Practice Address - City:GROTON
Practice Address - State:CT
Practice Address - Zip Code:06340-3812
Practice Address - Country:US
Practice Address - Phone:757-351-9224
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-19
Last Update Date:2025-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT11449171400000X, 172M00000X, 173C00000X, 225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No171400000XOther Service ProvidersHealth & Wellness Coach
No172M00000XOther Service ProvidersMechanotherapist
No173C00000XOther Service ProvidersReflexologist