Provider Demographics
NPI:1568759835
Name:HURD, GAIL DIANE (MS)
Entity Type:Individual
Prefix:
First Name:GAIL
Middle Name:DIANE
Last Name:HURD
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:GAIL
Other - Middle Name:
Other - Last Name:JOHNSTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:916 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44641-1842
Mailing Address - Country:US
Mailing Address - Phone:330-605-5619
Mailing Address - Fax:
Practice Address - Street 1:2181 AMBLESIDE DR
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-4645
Practice Address - Country:US
Practice Address - Phone:216-791-2285
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-06
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOT.007824225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist