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General NPI Number Information
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NPI Number | 1336423532
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Entity Type | Individual
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Provider Name | LISA MICHELE HARDEE M.S. CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 10/06/2011
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Last Update Date | 10/06/2011
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Provider Practice Location Address
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Address Line | 1601 W. TIMBERLANE DRIVE, SUITE 800
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City | PLANT CITY
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State | FL
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Zip | 33566
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Country | US
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Telephone | 813-707-9362
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Fax |
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Provider Business Mailing Address
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Address Line | 701 W. PINEDALE DRIVE
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City | PLANT CITY
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State | FL
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Zip | 33563
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Country | US
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Telephone | 813-679-2621
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SA9424
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License Number State | FL
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