# IVAN M HARDCASTLE

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1881816304
- **Gender:** Man
- **Credential:** MOT

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225X00000X | Occupational Therapist | OT-831 | ID | Yes |
| 225X00000X | Occupational Therapist | OTLP240 | ID | — |

## Other

- **Enumeration date:** 05/03/2007
- **Last updated:** 05/24/2023