Provider Demographics
NPI:1366672206
Name:HUGEE, JACQUELINE DELORES (CMT)
Entity type:Individual
Prefix:MS
First Name:JACQUELINE
Middle Name:DELORES
Last Name:HUGEE
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:JACQUELINE
Other - Middle Name:DELORES
Other - Last Name:REID
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CMT
Mailing Address - Street 1:4355 OAK MANOR DR NW
Mailing Address - Street 2:
Mailing Address - City:ACWORTH
Mailing Address - State:GA
Mailing Address - Zip Code:30101-5807
Mailing Address - Country:US
Mailing Address - Phone:770-875-1133
Mailing Address - Fax:757-923-4889
Practice Address - Street 1:2814 SPRING RD SE
Practice Address - Street 2:SUITE 201
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30339-3046
Practice Address - Country:US
Practice Address - Phone:770-875-1133
Practice Address - Fax:757-923-4889
Is Sole Proprietor?:No
Enumeration Date:2009-07-24
Last Update Date:2009-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMT003099225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist