MEDICARE: MRS. KIMBERLY LYNN ALLEN-HARDEY LMFT

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	106H00000X	Marriage & Family Therapist	MFC 44614	CA

General Provider Information

NPI Number	:	1093806119
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KIMBERLY LYNN ALLEN-HARDEY LMFT

Provider Business Mailing Address
First Line	:	8788 ELK GROVE BLVD
Second Line	:	BUILDING 3 SUITE 12D
City	:	ELK GROVE
State	:	CA
Zip	:	95624-1766
Country	:	US
Telephone Number	:	916-718-8638
Fax Number	:

Provider Business Practice Location Address
First Line	:	8788 ELK GROVE BLVD
Second Line	:	BUILDING 3 SUITE 12D
City	:	ELK GROVE
State	:	CA
Zip	:	95624-1766
Country	:	US
Telephone Number	:	916-718-8638
Fax Number	:

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

Provider Enumeration Date	:	09/27/2006
Last Update Date	:	10/28/2014

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