Healthcare Provider Details

I. General information

NPI: 1649514381
Provider Name (Legal Business Name): ERIN LYNN HURT M.S., CF-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ERIN LYNN DYKES M.S., CF-SLP

II. Dates (important events)

Enumeration Date: 11/19/2012
Last Update Date: 11/19/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7160 TCHULAHOMA RD BLDG. B, SUITE 4
SOUTHAVEN MS
38671-9266
US

IV. Provider business mailing address

7160 TCHULAHOMA RD BLDG. B, SUITE 4
SOUTHAVEN MS
38671-9266
US

V. Phone/Fax

Practice location:
  • Phone: 662-349-2733
  • Fax: 662-536-1849
Mailing address:
  • Phone: 662-349-2733
  • Fax: 662-536-1849

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: