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General NPI Number Information
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NPI Number | 1033635396
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Entity Type | Individual
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Provider Name | EMILY NICOLE HURST M.S., CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 08/18/2017
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Last Update Date | 10/20/2021
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Provider Practice Location Address
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Address Line | 816 FAYETTEVILLE RD
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City | VAN BUREN
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State | AR
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Zip | 72956-3423
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Country | US
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Telephone | 268-294-9479
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Fax |
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Provider Business Mailing Address
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Address Line | 630 CHAPEN WAY
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City | ALMA
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State | AR
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Zip | 72921-8502
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Country | US
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Telephone | 479-462-9135
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | P9195
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License Number State | AR
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