Healthcare Provider Details

I. General information

NPI: 1154013787
Provider Name (Legal Business Name): SHAUNA HUGULEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2023
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

312 WALLER MILL RD
WILLIAMSBURG VA
23185-3000
US

IV. Provider business mailing address

312 WALLER MILL RD
WILLIAMSBURG VA
23185-3000
US

V. Phone/Fax

Practice location:
  • Phone: 757-566-3300
  • Fax: 757-566-8977
Mailing address:
  • Phone: 757-566-3300
  • Fax: 757-566-8977

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number2202011422
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: