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NPI Code Detail

MEDICARE: ADRINE DEMAUDE HARDY M.ED.

MEDICARE: ADRINE DEMAUDE HARDY M.ED.
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
1101YP2500XProfessional Counselor174011KY

General Provider Information

NPI Number : 1861765802
Entity Type Code : Individual
Provider Name (Legal Business Name) : ADRINE DEMAUDE HARDY M.ED.
Provider Business Mailing Address
First Line : 7022 BLACK MOUNTAIN DR
Second Line :
City : LOUISVILLE
State : KY
Zip : 40228-2829
Country : US
Telephone Number : 502-298-6021
Fax Number :
Provider Business Practice Location Address
First Line : 2301 GOLDSMITH LN
Second Line :
City : LOUISVILLE
State : KY
Zip : 40218-1018
Country : US
Telephone Number : 502-451-4701
Fax Number : 502-451-4754
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/22/2012
Last Update Date : 11/28/2017

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