Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | OT 007043 | OH |
Y | 225XP0200X | Occupational Therapist - Pediatrics | OT19354 | FL |
NPI | 1013195676 |
---|---|
Provider Name | Desiree Carolina Hardwick |
First Address | Spring Hill, FL 34609-0643 |
Second Address | Brooksville, FL 34601-3119 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/02/2008 |
Last Update Date | 03/04/2021 |