Healthcare Provider Details

I. General information

NPI: 1760310841
Provider Name (Legal Business Name): ALLYSE HARDY MT-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1003 IN-662 W
NEWBURGH IN
47630
US

IV. Provider business mailing address

1003 STATE ROUTE 662 W
NEWBURGH IN
47630-1006
US

V. Phone/Fax

Practice location:
  • Phone: 812-490-9400
  • Fax:
Mailing address:
  • Phone: 812-490-9400
  • Fax: 888-715-3298

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number18890
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: