MEDICARE: ROBYN ANNE HARDCASTLE

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
1	101Y00000X	Counselor

General Provider Information

NPI Number	:	1568667459
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBYN ANNE HARDCASTLE

Provider Business Mailing Address
First Line	:	860 E 4500 S STE 202
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84107-3014
Country	:	US
Telephone Number	:	801-262-9619
Fax Number	:	801-262-9630

Provider Business Practice Location Address
First Line	:	860 E 4500 S STE 202
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84107-3014
Country	:	US
Telephone Number	:	801-262-9619
Fax Number	:	801-262-9630

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/19/2007
Last Update Date	:	11/27/2012

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