Provider Demographics
NPI:1225443559
Name:HURWITZ, DEVORA
Entity Type:Individual
Prefix:
First Name:DEVORA
Middle Name:
Last Name:HURWITZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DEVORA
Other - Middle Name:
Other - Last Name:RAITMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3007 BOGOTA AVE
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33026-4509
Mailing Address - Country:US
Mailing Address - Phone:718-686-3700
Mailing Address - Fax:
Practice Address - Street 1:3007 BOGOTA AVE
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33026-4509
Practice Address - Country:US
Practice Address - Phone:718-686-3700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-25
Last Update Date:2020-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X, 103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No174400000XOther Service ProvidersSpecialist