Healthcare Provider Details

I. General information

NPI: 1063595551
Provider Name (Legal Business Name): DOROTHY HURD LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/20/2006
Last Update Date: 05/16/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 E LEXINGTON AVE SUITE B
PHOENIX AZ
85012-2321
US

IV. Provider business mailing address

99 E VIRGINIA AVE SUITE 275
PHOENIX AZ
85004-1195
US

V. Phone/Fax

Practice location:
  • Phone: 480-620-2887
  • Fax: 602-253-4228
Mailing address:
  • Phone: 602-264-4600
  • Fax: 602-264-7325

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC-0168
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: