Healthcare Provider Details

I. General information

NPI: 1164353223
Provider Name (Legal Business Name): SANDRA RAE HUGHES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/27/2026
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9120 HIGHWAY 48
ROSENDALE MO
64483-9115
US

IV. Provider business mailing address

197 STATE RTE N
BOLCKOW MO
64427-9103
US

V. Phone/Fax

Practice location:
  • Phone: 816-567-2527
  • Fax: 816-567-2096
Mailing address:
  • Phone: 816-390-6672
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number0317338
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: