Healthcare Provider Details

I. General information

NPI: 1508789561
Provider Name (Legal Business Name): HEIDI HARDBARGER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2026
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1220 HEBRON RD
HEATH OH
43056-1040
US

IV. Provider business mailing address

1220 HEBRON RD
HEATH OH
43056-1040
US

V. Phone/Fax

Practice location:
  • Phone: 740-763-0408
  • Fax: 740-763-0475
Mailing address:
  • Phone: 740-763-0408
  • Fax: 740-763-0475

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License NumberOTA004653
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: