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NPI Code Detail

MEDICARE: FELICIA HURST THERAPY LLC

MEDICARE: FELICIA HURST THERAPY LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM0850XAdult Mental Health Clinic/Center

General Provider Information

NPI Number : 1063903839
Entity Type Code : Organization
Provider Name (Legal Business Name) : FELICIA HURST THERAPY LLC
Provider Business Mailing Address
First Line : 302505 STATE HIGHWAY 53
Second Line :
City : HEALDTON
State : OK
Zip : 73438-4109
Country : US
Telephone Number : 918-916-9896
Fax Number :
Provider Business Practice Location Address
First Line : 2007 N COMMERCE ST STE 212
Second Line :
City : ARDMORE
State : OK
Zip : 73401-1268
Country : US
Telephone Number : 918-916-9896
Fax Number :
Authorized Official
Title or Position : CLINICAL MENTAL HEALTH THERAPIST
Name : MRS. FELICIA BETH HURST
Credential : MS
Telephone Number : 918-916-9896
Provider Enumeration Date : 05/28/2018
Last Update Date : 05/28/2018

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Directions to “FELICIA HURST THERAPY LLC ” Practice Location

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