MEDICARE: MS. LAURA MARIA HUGHES MFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	MFC 14135	CA

General Provider Information

NPI Number	:	1043416738
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LAURA MARIA HUGHES MFT

Provider Business Mailing Address
First Line	:	1746 S VICTORIA AVE STE F PMB 205
Second Line	:
City	:	VENTURA
State	:	CA
Zip	:	93003-6190
Country	:	US
Telephone Number	:	805-642-3661
Fax Number	:	805-659-3265

Provider Business Practice Location Address
First Line	:	3585 MAPLE ST
Second Line	:	265
City	:	VENTURA
State	:	CA
Zip	:	93003-3504
Country	:	US
Telephone Number	:	805-642-3661
Fax Number	:	805-659-3265

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/21/2007
Last Update Date	:	07/08/2007

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