Provider Demographics
NPI:1659049252
Name:HURD, KIMBERLY A (RBT)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:A
Last Name:HURD
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1421 NW 165TH CT
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73012-7089
Mailing Address - Country:US
Mailing Address - Phone:405-285-7622
Mailing Address - Fax:
Practice Address - Street 1:1421 NW 165TH CT
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73012-7089
Practice Address - Country:US
Practice Address - Phone:405-285-7622
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-31
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician