Individual
SHANICE HARDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4306 S GRAND ST, MONROE, LA 71202-6322
(318) 324-5441
Mailing address
4306 S GRAND ST, MONROE, LA 71202-6322
(318) 324-5441
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
175T00000X
Peer Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1528503612
—
LA
Enumeration date
12/27/2016
Last updated
03/20/2020
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