Provider Demographics
NPI:1871879684
Name:COUCH HUGHES, AMY (LMT)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:COUCH HUGHES
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1017 VASSAR DR SE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87106-2956
Mailing Address - Country:US
Mailing Address - Phone:505-710-6960
Mailing Address - Fax:
Practice Address - Street 1:231 SIERRA DR SE # 3
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87108-2714
Practice Address - Country:US
Practice Address - Phone:505-710-6960
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-25
Last Update Date:2011-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM3630225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist