Healthcare Provider Details

I. General information

NPI: 1386242865
Provider Name (Legal Business Name): KRISTINE HURLEY OTR/L, CHT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/15/2020
Last Update Date: 10/15/2020
Certification Date: 10/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

910 E WHITESTONE BLVD
CEDAR PARK TX
78613-9093
US

IV. Provider business mailing address

1313 ITZEL BND
LEANDER TX
78641-4106
US

V. Phone/Fax

Practice location:
  • Phone: 737-237-0031
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number121026
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: