MEDICARE: CARRIE HURLEY BCBA

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
1	103K00000X	Behavior Analyst	1-24-71025	GA

General Provider Information

NPI Number	:	1962265405
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARRIE HURLEY BCBA

Provider Business Mailing Address
First Line	:	650 SCRANTON RD STE C
Second Line	:
City	:	BRUNSWICK
State	:	GA
Zip	:	31520-1930
Country	:	US
Telephone Number	:	912-275-8697
Fax Number	:

Provider Business Practice Location Address
First Line	:	650 SCRANTON RD STE C
Second Line	:
City	:	BRUNSWICK
State	:	GA
Zip	:	31520-1930
Country	:	US
Telephone Number	:	912-275-8697
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/06/2024
Last Update Date	:	12/08/2025

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Directions to “ CARRIE HURLEY BCBA” Practice Location

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