Provider Demographics
NPI:1558961524
Name:HURLEY, MELBA
Entity Type:Individual
Prefix:DR
First Name:MELBA
Middle Name:
Last Name:HURLEY
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 1:4295 BLUE SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:RED SPRINGS
Mailing Address - State:NC
Mailing Address - Zip Code:28377-8577
Mailing Address - Country:US
Mailing Address - Phone:917-655-7430
Mailing Address - Fax:
Practice Address - Street 1:4295 BLUE SPRINGS RD
Practice Address - Street 2:
Practice Address - City:RED SPRINGS
Practice Address - State:NC
Practice Address - Zip Code:28377-8577
Practice Address - Country:US
Practice Address - Phone:917-655-7430
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-29
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral