Individual
TIMOTHY P HURLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MAC, PLMHP
Contact information
Practice address
1811 W 2ND ST STE 420, GRAND ISLAND, NE 68803-5468
(402) 910-2636
Mailing address
2220 VIKING RD, GRAND ISLAND, NE 68803-2249
(402) 910-2636
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
11055
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11055
PROVISIONAL LICENSED MENTAL HEALTH PRACTITIONER
NE
Enumeration date
11/03/2017
Last updated
11/03/2017
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