Provider Demographics
NPI:1962164582
Name:HURST, HANNAH KIMBERLY
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:KIMBERLY
Last Name:HURST
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:926 DESALES ST
Mailing Address - Street 2:
Mailing Address - City:VANDALIA
Mailing Address - State:OH
Mailing Address - Zip Code:45377-1126
Mailing Address - Country:US
Mailing Address - Phone:937-231-5413
Mailing Address - Fax:
Practice Address - Street 1:926 DESALES ST
Practice Address - Street 2:
Practice Address - City:VANDALIA
Practice Address - State:OH
Practice Address - Zip Code:45377-1126
Practice Address - Country:US
Practice Address - Phone:937-231-5413
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-11
Last Update Date:2021-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health