Healthcare Provider Details

I. General information

NPI: 1740077429
Provider Name (Legal Business Name): SYDNEY DANIELLE HURT PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2025
Last Update Date: 04/24/2025
Certification Date: 04/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 FORT ROOTS DR
NORTH LITTLE ROCK AR
72114-1709
US

IV. Provider business mailing address

601 NAPA VALLEY DR APT 418
LITTLE ROCK AR
72211-2361
US

V. Phone/Fax

Practice location:
  • Phone: 501-257-3087
  • Fax:
Mailing address:
  • Phone: 662-251-1887
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number202345
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: