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General NPI Number Information
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NPI Number | 1063052926
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Entity Type | Individual
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Provider Name | DE'JA M HURTE
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Gender | Female
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Dates
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Enumeration Date | 01/08/2020
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Last Update Date | 07/29/2024
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Provider Practice Location Address
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Address Line | 711 E JOSEPHINE ST
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City | SAN ANTONIO
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State | TX
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Zip | 78208-1027
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Country | US
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Telephone | 210-261-3800
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Fax | 210-261-1807
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Provider Business Mailing Address
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Address Line | 6800 PARK TEN BLVD STE 200S
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City | SAN ANTONIO
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State | TX
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Zip | 78213-4293
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Country | US
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Telephone | 210-261-1060
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Fax | 210-261-1821
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 93630
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License Number State | TX
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