Provider Demographics
NPI:1063763845
Name:HURLIMANN, KELLY RENNER (MFT)
Entity type:Individual
Prefix:MS
First Name:KELLY
Middle Name:RENNER
Last Name:HURLIMANN
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:MRS
Other - First Name:KELLY
Other - Middle Name:RENNER
Other - Last Name:MOORE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MFT
Mailing Address - Street 1:1762 CENTURY BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30345-3393
Mailing Address - Country:US
Mailing Address - Phone:404-633-0250
Mailing Address - Fax:404-475-0331
Practice Address - Street 1:1762 CENTURY BLVD NE
Practice Address - Street 2:SUITE B
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30345-3393
Practice Address - Country:US
Practice Address - Phone:404-633-0250
Practice Address - Fax:404-475-0331
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-20
Last Update Date:2012-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist