Provider Demographics
NPI:1962641928
Name:HURYN, THEODORE FRANK (M A, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:THEODORE
Middle Name:FRANK
Last Name:HURYN
Suffix:
Gender:M
Credentials:M A, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4950 WILSON LN
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17055-4442
Mailing Address - Country:US
Mailing Address - Phone:717-691-4840
Mailing Address - Fax:717-790-8585
Practice Address - Street 1:4950 WILSON LN
Practice Address - Street 2:
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17055-4442
Practice Address - Country:US
Practice Address - Phone:717-691-4840
Practice Address - Fax:717-790-8585
Is Sole Proprietor?:No
Enumeration Date:2009-02-16
Last Update Date:2009-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL000646L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist