Provider Demographics
NPI:1679326870
Name:HURD, SYDNEY (OTR/L)
Entity Type:Individual
Prefix:
First Name:SYDNEY
Middle Name:
Last Name:HURD
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 CORPORATE DR STE 150
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37604-2008
Mailing Address - Country:US
Mailing Address - Phone:423-617-0207
Mailing Address - Fax:423-617-0242
Practice Address - Street 1:110 CORPORATE DR STE 150
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37604-2008
Practice Address - Country:US
Practice Address - Phone:423-617-0207
Practice Address - Fax:423-617-0242
Is Sole Proprietor?:No
Enumeration Date:2024-04-08
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN7952225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist