Provider Demographics
NPI:1023725116
Name:HUGHES, RANDY BYRAM (MA)
Entity type:Individual
Prefix:
First Name:RANDY
Middle Name:BYRAM
Last Name:HUGHES
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1075 S CHECK ST STE 208
Mailing Address - Street 2:
Mailing Address - City:WASILLA
Mailing Address - State:AK
Mailing Address - Zip Code:99654-8067
Mailing Address - Country:US
Mailing Address - Phone:907-521-8504
Mailing Address - Fax:
Practice Address - Street 1:1075 S CHECK ST STE 208
Practice Address - Street 2:
Practice Address - City:WASILLA
Practice Address - State:AK
Practice Address - Zip Code:99654-8067
Practice Address - Country:US
Practice Address - Phone:907-521-8504
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-31
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral