Provider Demographics
NPI:1437314069
Name:HURT, HEATHER LYNNAE (SLPA)
Entity Type:Individual
Prefix:MISS
First Name:HEATHER
Middle Name:LYNNAE
Last Name:HURT
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:LYNNAE
Other - Last Name:OSHINOWO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2321 AVENUE H APT B1205
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75050-8308
Mailing Address - Country:US
Mailing Address - Phone:708-296-9750
Mailing Address - Fax:
Practice Address - Street 1:2321 AVENUE H APT B1205
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75050
Practice Address - Country:US
Practice Address - Phone:708-296-9750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-23
Last Update Date:2018-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst