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NPI Code Detail

MEDICARE: DAKOTAH HARDY LBA

MEDICARE: DAKOTAH HARDY LBA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst5396TX

General Provider Information

NPI Number : 1184224594
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAKOTAH HARDY LBA
Provider Business Mailing Address
First Line : 1824 TOUBY PIKE STE B
Second Line :
City : KOKOMO
State : IN
Zip : 46901-2573
Country : US
Telephone Number : 281-407-1690
Fax Number :
Provider Business Practice Location Address
First Line : 2220 H G MOSLEY PKWY
Second Line :
City : LONGVIEW
State : TX
Zip : 75604-3663
Country : US
Telephone Number : 281-407-1690
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/27/2020
Last Update Date : 03/29/2023

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Directions to “ DAKOTAH HARDY LBA” Practice Location

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