Provider Demographics
NPI:1982856217
Name:HURD, DIANE ANDREA (MA CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:DIANE
Middle Name:ANDREA
Last Name:HURD
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 ANDOVER RD
Mailing Address - Street 2:
Mailing Address - City:HARTSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10530-2024
Mailing Address - Country:US
Mailing Address - Phone:914-287-0727
Mailing Address - Fax:914-287-0727
Practice Address - Street 1:17 ANDOVER RD
Practice Address - Street 2:
Practice Address - City:HARTSDALE
Practice Address - State:NY
Practice Address - Zip Code:10530-2024
Practice Address - Country:US
Practice Address - Phone:914-287-0727
Practice Address - Fax:914-287-0727
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-17
Last Update Date:2008-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002185-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist