Healthcare Provider Details

I. General information

NPI: 1558751131
Provider Name (Legal Business Name): LEIGH HURST
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/03/2015
Last Update Date: 02/03/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4868 BOUGAINVILLEA DR
SPARKS NV
89436-7383
US

IV. Provider business mailing address

4868 BOUGAINVILLEA DR
SPARKS NV
89436-7383
US

V. Phone/Fax

Practice location:
  • Phone: 775-688-9837
  • Fax: 775-360-5363
Mailing address:
  • Phone: 775-688-9837
  • Fax: 775-360-5363

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: