Provider Demographics
NPI:1538208814
Name:HURDLE, CONNIE MARIE (LMFT)
Entity type:Individual
Prefix:
First Name:CONNIE
Middle Name:MARIE
Last Name:HURDLE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:CONNIE
Other - Middle Name:M
Other - Last Name:HURDLE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMFT
Mailing Address - Street 1:1414 S MILLER ST STE D
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93454-6915
Mailing Address - Country:US
Mailing Address - Phone:805-748-6677
Mailing Address - Fax:334-564-8631
Practice Address - Street 1:1414 S MILLER ST STE D
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93454-6915
Practice Address - Country:US
Practice Address - Phone:805-748-6677
Practice Address - Fax:334-564-8631
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT34265106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist