Individual
JACKIE HURST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSCCC-SLP
Contact information
Practice address
3903 N HARRISON ST, SHAWNEE, OK 74804-1426
(405) 585-2971
(405) 585-2983
Mailing address
3903 N HARRISON ST, SHAWNEE, OK 74804-1426
(405) 585-2971
(405) 585-2983
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2892
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200088030A
—
OK
Enumeration date
10/13/2006
Last updated
06/09/2025
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