Healthcare Provider Details
I. General information
NPI: 1861007007
Provider Name (Legal Business Name): ALEXINA LEORA HURLEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/14/2020
Last Update Date: 09/14/2020
Certification Date: 09/14/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
262 WESTFIELD RD
HOLYOKE MA
01040-1662
US
IV. Provider business mailing address
346 LINCOLN AVE APT B
AMHERST MA
01002-1920
US
V. Phone/Fax
- Phone: 888-805-0759
- Fax:
- Phone: 781-281-4106
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 106S00000X |
| Taxonomy | Behavior Technician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: