Healthcare Provider Details

I. General information

NPI: 1447674478
Provider Name (Legal Business Name): RACHEL HURFORD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/11/2014
Last Update Date: 02/11/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

855 CENTRAL DR
ODESSA TX
79761-4200
US

IV. Provider business mailing address

4001 FAUDREE RD APT K205
ODESSA TX
79765-5035
US

V. Phone/Fax

Practice location:
  • Phone: 432-614-5720
  • Fax: 877-729-4033
Mailing address:
  • Phone: 432-634-2500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number70181
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number70181
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number70181
License Number StateTX
# 4
Primary TaxonomyN
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number14397
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: