Provider Demographics
NPI:1881035301
Name:HURLEY, KATHY LEE (PHD, THD, BCBA-D)
Entity Type:Individual
Prefix:MRS
First Name:KATHY
Middle Name:LEE
Last Name:HURLEY
Suffix:
Gender:F
Credentials:PHD, THD, BCBA-D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:650 MAITLAND AVE
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32701-6862
Mailing Address - Country:US
Mailing Address - Phone:407-975-0400
Mailing Address - Fax:407-696-4831
Practice Address - Street 1:1544 SEMINOLA BLVD SUITE 116
Practice Address - Street 2:
Practice Address - City:CASSELBERRY
Practice Address - State:FL
Practice Address - Zip Code:32701
Practice Address - Country:US
Practice Address - Phone:407-636-9814
Practice Address - Fax:407-775-5039
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-12
Last Update Date:2016-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-14-3219103K00000X
FLMH7702101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health