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General NPI Number Information
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NPI Number | 1417359506
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Entity Type | Individual
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Provider Name | FLORENCE HARDJONO PHD-SLP
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Gender | Female
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Dates
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Enumeration Date | 09/19/2014
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Last Update Date | 09/28/2023
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Provider Practice Location Address
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Address Line | 3769 ATTUCKS DR
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City | POWELL
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State | OH
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Zip | 43065-6080
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Country | US
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Telephone | 614-467-0131
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Fax |
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Provider Business Mailing Address
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Address Line | 3906 LAUREL VALLEY DR
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City | POWELL
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State | OH
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Zip | 43065-8093
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Country | US
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Telephone | 614-459-2429
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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 | COND.2015098-SP
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SP12384
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License Number State | OH
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