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General NPI Number Information
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NPI Number | 1023968914
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Entity Type | Individual
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Provider Name | MALIK HARDY
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Gender | Male
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Dates
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Enumeration Date | 01/30/2026
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Last Update Date | 01/30/2026
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Provider Practice Location Address
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Address Line | 7491 MOSSDALE WAY
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City | COLUMBUS
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State | GA
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Zip | 31909-1787
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Country | US
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Telephone | 850-293-1575
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Fax |
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Provider Business Mailing Address
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Address Line | 1 CYPRESS PT W
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City | PENSACOLA
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State | FL
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Zip | 32514-7930
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Country | US
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Telephone | 850-293-1575
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | RBT-25-491241
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License Number State | GA
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