Organization
KERSTIN P. HURLEY, PHD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN P MELK MD (CEO)
(520) 364-1429
Entity
Organization
Contact information
Practice address
155 CALLE PORTAL, SUITE 300, SIERRA VISTA, AZ 85635-2900
(520) 459-3011
(520) 458-4467
Mailing address
155 CALLE PORTAL, SUITE 100, SIERRA VISTA, AZ 85635-2900
(520) 459-3012
(520) 459-3207
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY 27306
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4689
ARIZONA STATE BOARD OF PSYCHOLOGY
AZ
Enumeration date
10/12/2015
Last updated
12/31/2015
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