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NPI Code Detail

MEDICARE: MADISON ROSE HARDY MFT-I

MEDICARE: MADISON ROSE HARDY MFT-I
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
1106H00000XMarriage & Family Therapist

General Provider Information

NPI Number : 1972250322
Entity Type Code : Individual
Provider Name (Legal Business Name) : MADISON ROSE HARDY MFT-I
Provider Business Mailing Address
First Line : 675 S GREEN VALLEY PKWY # 1094
Second Line :
City : HENDERSON
State : NV
Zip : 89052-0404
Country : US
Telephone Number : 702-748-7580
Fax Number :
Provider Business Practice Location Address
First Line : 1172 WHISPERING BIRCH AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89123-5857
Country : US
Telephone Number : 702-401-0035
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/06/2022
Last Update Date : 03/06/2022

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Directions to “ MADISON ROSE HARDY MFT-I” Practice Location

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