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NPI 1578693479

NPI 1578693479 : RHONDA K HURT MA : O FALLON, MO

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General NPI Number Information
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    NPI Number           |    1578693479
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    Entity Type          |    Individual 
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    Provider Name        |    RHONDA K HURT MA
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    03/07/2007
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    Last Update Date     |    02/19/2009
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Provider Practice Location Address
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    Address Line         |    110 VIRGIL ST FT ZUMWALT R-II
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    City                 |    O FALLON
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    State                |    MO
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    Zip                  |    63366-2637
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    Country              |    US
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    Telephone            |    636-272-1059
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    Fax                  |    636-980-1946
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Provider Business Mailing Address
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    Address Line         |    110 VIRGIL ST 
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    City                 |    O FALLON
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    State                |    MO
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    Zip                  |    63366-2637
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    Country              |    US
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    Telephone            |    636-272-1059
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    Fax                  |    636-980-1946
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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       |    00826
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    License Number State |    MO
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