Provider Demographics
NPI:1154616225
Name:HURTADO SHORT, JATZEN SAYLEEN (MS)
Entity type:Individual
Prefix:MISS
First Name:JATZEN
Middle Name:SAYLEEN
Last Name:HURTADO SHORT
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 S HOUGHTON RD STE 138-145
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85748-6731
Mailing Address - Country:US
Mailing Address - Phone:520-304-5938
Mailing Address - Fax:
Practice Address - Street 1:11040 E CACTUS SPINE RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85748-3557
Practice Address - Country:US
Practice Address - Phone:520-304-5938
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-16
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLP9056235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist