Basic Information
Provider Information
NPI: 1841709094
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HURRY
FirstName: KATHRYN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: GRABSKI
OtherFirstName: KATHRYN
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: 6867 AVALON AVE
Address2:  
City: DALLAS
State: TX
PostalCode: 752143775
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 320 WESTWAY PL
Address2:  
City: ARLINGTON
State: TX
PostalCode: 760185245
CountryCode: US
TelephoneNumber: 8175169100
FaxNumber:  
Other Information
ProviderEnumerationDate: 09/20/2017
LastUpdateDate: 09/20/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YM0800X  Y Behavioral Health & Social Service ProvidersCounselorMental Health

No ID Information.


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