Healthcare Provider Details

I. General information

NPI: 1447448352
Provider Name (Legal Business Name): HEIDI LYN HARDMAN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2007
Last Update Date: 10/05/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

411 OAK ST
CINCINNATI OH
45219-2504
US

IV. Provider business mailing address

121 HIGH BLUFF DR
GURLEY AL
35748-9119
US

V. Phone/Fax

Practice location:
  • Phone: 513-984-1800
  • Fax: 513-984-4909
Mailing address:
  • Phone: 256-776-6688
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number1254C
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: