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NPI Code Detail

MEDICARE: DUEWING HARDRICK

MEDICARE: DUEWING HARDRICK
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
1106S00000XBehavior Technician
2172V00000XCommunity Health Worker

General Provider Information

NPI Number : 1093332710
Entity Type Code : Individual
Provider Name (Legal Business Name) : DUEWING HARDRICK
Provider Business Mailing Address
First Line : 15490 CIVIC DR STE 103
Second Line :
City : VICTORVILLE
State : CA
Zip : 92392-2382
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 15490 CIVIC DR STE 103
Second Line :
City : VICTORVILLE
State : CA
Zip : 92392-2382
Country : US
Telephone Number : 442-327-9172
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/29/2020
Last Update Date : 11/20/2024

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Directions to “ DUEWING HARDRICK ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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