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NPI Code Detail

MEDICARE: SHELBY LYNN HARDY

MEDICARE: SHELBY LYNN HARDY
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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1790047165
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHELBY LYNN HARDY
Provider Business Mailing Address
First Line : 333 SKYWAY DR
Second Line :
City : CAMARILLO
State : CA
Zip : 93010-8552
Country : US
Telephone Number : 805-383-1155
Fax Number :
Provider Business Practice Location Address
First Line : 333 SKYWAY DR
Second Line :
City : CAMARILLO
State : CA
Zip : 93010-8552
Country : US
Telephone Number : 805-383-1155
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/12/2012
Last Update Date : 01/31/2017

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Directions to “ SHELBY LYNN HARDY ” Practice Location

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