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General NPI Number Information
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NPI Number | 1104184142
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Entity Type | Organization
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Legal Business Name | HURD COUNSELING AND EDUCATIONAL PSYCHOLOGY
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Dates
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Enumeration Date | 04/27/2012
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Last Update Date | 04/27/2012
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Provider Practice Location Address
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Address Line | 700 RAYOVAC DRIVE
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City | MADISON
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State | WI
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Zip | 53711
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Country | US
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Telephone | 608-228-0750
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Fax |
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Provider Business Mailing Address
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Address Line | 7580 VALLEY WOODS CT
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City | VERONA
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State | WI
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Zip | 53593-9569
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Country | US
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Telephone | 608-228-0750
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Fax |
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Authorized Official
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Title or Position | LICENSED PSYCHOLOGIST
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Name | DR. HEATHER DOESCHER HURD
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Credential | PH.D.
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Telephone | 608-228-0750
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 2890-057
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License Number State | WI
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