Healthcare Provider Details

I. General information

NPI: 1609672872
Provider Name (Legal Business Name): HEIDI LYNN HUGHES LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/19/2025
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 LONG HILL RD STE 1A
GROTON CT
06340-3823
US

IV. Provider business mailing address

PO BOX 685
GALES FERRY CT
06335-0685
US

V. Phone/Fax

Practice location:
  • Phone: 757-351-9224
  • Fax:
Mailing address:
  • Phone: 757-351-9224
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number11449
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code173C00000X
TaxonomyReflexologist
License Number11449
License Number StateCT
# 3
Primary TaxonomyN
Taxonomy Code172M00000X
TaxonomyMechanotherapist
License Number11449
License Number StateCT
# 4
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number11449
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: