Healthcare Provider Details

I. General information

NPI: 1477398063
Provider Name (Legal Business Name): HURLEY DEVELOPMENTAL THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2024
Last Update Date: 06/26/2024
Certification Date: 06/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 SADDLE CRK
PADUCAH KY
42001-7802
US

IV. Provider business mailing address

150 SADDLE CRK
PADUCAH KY
42001-7802
US

V. Phone/Fax

Practice location:
  • Phone: 270-217-8575
  • Fax:
Mailing address:
  • Phone: 270-217-8575
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: MEGHAN L HURLEY
Title or Position: DI
Credential:
Phone: 270-217-8575