MEDICARE: DELLA K HARDY LICSW

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	104100000X	Social Worker	1016292	MA

General Provider Information

NPI Number	:	1093840498
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DELLA K HARDY LICSW

Provider Business Mailing Address
First Line	:	1 ABBOTT LN
Second Line	:
City	:	IPSWICH
State	:	MA
Zip	:	01938-1043
Country	:	US
Telephone Number	:	978-887-4061
Fax Number	:	978-664-0717

Provider Business Practice Location Address
First Line	:	599 NORTH AVE
Second Line	:	DR8
City	:	WAKEFIELD
State	:	MA
Zip	:	01880-1648
Country	:	US
Telephone Number	:	978-887-4061
Fax Number	:	978-664-0717

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

Provider Enumeration Date	:	02/23/2007
Last Update Date	:	07/08/2007

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Directions to “ DELLA K HARDY LICSW” Practice Location

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