Healthcare Provider Details

I. General information

NPI: 1609556760
Provider Name (Legal Business Name): LIANA HURLEY LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/24/2023
Last Update Date: 07/24/2023
Certification Date: 07/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5282 MEDICAL DR STE 605
SAN ANTONIO TX
78229-6114
US

IV. Provider business mailing address

161 BOBWHITE WAY
SAN ANTONIO TX
78253-6978
US

V. Phone/Fax

Practice location:
  • Phone: 210-271-3630
  • Fax: 210-444-2171
Mailing address:
  • Phone: 210-559-6436
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number86070
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: