Provider Demographics
NPI:1992859201
Name:HURD, KELLY LEIGH (MS CCC-A)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:LEIGH
Last Name:HURD
Suffix:
Gender:F
Credentials:MS CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:144 GENESEE ST
Mailing Address - Street 2:METCALF PLAZA
Mailing Address - City:AUBURN
Mailing Address - State:NY
Mailing Address - Zip Code:13021-3503
Mailing Address - Country:US
Mailing Address - Phone:315-282-7364
Mailing Address - Fax:315-282-7567
Practice Address - Street 1:144 GENESEE ST
Practice Address - Street 2:METCALF PLAZA
Practice Address - City:AUBURN
Practice Address - State:NY
Practice Address - Zip Code:13021-3503
Practice Address - Country:US
Practice Address - Phone:315-282-7364
Practice Address - Fax:315-282-7567
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2011-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI1601000487237600000X
NY0017201237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter