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NPI Code Detail

MEDICARE: MRS. KEYNIA DIONNE HARDLEY LMFT

MEDICARE:  MRS. KEYNIA DIONNE HARDLEY  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
1106H00000XMarriage & Family Therapist0001624GA

General Provider Information

NPI Number : 1265929517
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KEYNIA DIONNE HARDLEY LMFT
Provider Business Mailing Address
First Line : 863 DUNCAN RD
Second Line :
City : OXFORD
State : GA
Zip : 30054-3679
Country : US
Telephone Number : 678-372-6779
Fax Number :
Provider Business Practice Location Address
First Line : 8218 HAZELBRAND RD NE STE A
Second Line :
City : COVINGTON
State : GA
Zip : 30014-1516
Country : US
Telephone Number : 678-609-8203
Fax Number : 678-729-8006
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/21/2018
Last Update Date : 08/18/2022

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Directions to “ MRS. KEYNIA DIONNE HARDLEY LMFT” Practice Location

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