Healthcare Provider Details

I. General information

NPI: 1992879910
Provider Name (Legal Business Name): RANDY K HARDMAN PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/20/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1790 N STATE STREET
OREM UT
84057-2025
US

IV. Provider business mailing address

1790 N STATE STREET
OREM UT
84057
US

V. Phone/Fax

Practice location:
  • Phone: 801-224-8255
  • Fax: 801-224-8301
Mailing address:
  • Phone: 801-224-8255
  • Fax: 801-224-8301

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number115015-2501
License Number StateUT
# 2
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number115015-2501
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: