MEDICARE: DESIREE CAROLINA HARDWICK OTR/L; NTMTC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225XP0200X	Pediatric Occupational Therapist	OT19354	FL
2	225X00000X	Occupational Therapist	OT 007043	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1013195676
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DESIREE CAROLINA HARDWICK OTR/L; NTMTC

Provider Business Mailing Address
First Line	:	13163 HAVERHILL DR
Second Line	:
City	:	SPRING HILL
State	:	FL
Zip	:	34609-0643
Country	:	US
Telephone Number	:	915-253-1691
Fax Number	:

Provider Business Practice Location Address
First Line	:	12601 SPRING HILL DR
Second Line	:
City	:	SPRING HILL
State	:	FL
Zip	:	34609-5009
Country	:	US
Telephone Number	:	352-559-9500
Fax Number	:	352-559-0585

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/06/2008
Last Update Date	:	05/12/2022

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