Healthcare Provider Details

I. General information

NPI: 1487931812
Provider Name (Legal Business Name): LUANN M HURD C.R.C., L.P.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/14/2011
Last Update Date: 04/27/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

808 E. CHICAGO BLVD. SUITE 14
TECUMSEH MI
49286
US

IV. Provider business mailing address

808 E. CHICAGO BLVD. SUITE 14
TECUMSEH MI
49286
US

V. Phone/Fax

Practice location:
  • Phone: 517-879-5838
  • Fax: 517-879-5838
Mailing address:
  • Phone: 517-879-5838
  • Fax: 517-879-5838

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6401009777
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: