Individual
AMY M HURST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA CCC/SLP
Contact information
Practice address
135 PINECONE DR, SPRINGBORO, OH 45066-9771
(937) 474-5455
Mailing address
135 PINECONE DR, SPRINGBORO, OH 45066-9771
(937) 474-5455
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP8483
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0510772
—
OH
01
—
310592919
TRICARE
OH
01
—
31059291900
BWC
OH
01
—
310592919026
CARESOURCE
OH
01
—
4620006
UNITED HEALTHCARE
OH
Enumeration date
09/08/2008
Last updated
11/07/2011
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