Doctor Name: | DAVID SCOTT HURST |
NPI Number: | 1184082927 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LPC, NCC |
License Number: | LPC-5936 |
Business Practice Address: | 1309 Camas St Blackfoot, ID - 832213060 |
Business Phone Number: | 2087820678 |
Business Fax Number: | |
Mailing Address: | 1309 Camas St, BLACKFOOT |
State: | ID |
Postal Code: | 832213060 |
Phone Number: | 2087820678 |
Fax Number: | |
NPI Enumeration Date: | 02/08/2016 |
NPI Last Update Date: | 02/08/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | LPC-5936 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ID |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |