Individual
JACQUELINE HARDISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
8282 WHITE OAK AVE STE 107, RANCHO CUCAMONGA, CA 91730-7681
(909) 476-9071
(909) 929-0805
Mailing address
8282 WHITE OAK AVE STE 107, RANCHO CUCAMONGA, CA 91730-7681
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Enumeration date
11/15/2019
Last updated
11/15/2019
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