Individual
MARIE NICOLE HARDAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
5404 CYPRESS CENTER DR, TAMPA, FL 33609-1044
(804) 904-6518
Mailing address
593 OZONA VILLAGE DRIVE, PALM HARBOR, FL 34683
(727) 804-3933
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
ISW 7292
FL
104100000X
Social Worker
Primary
SW128367
PA
1041C0700X
Clinical Social Worker
0904008799
VA
1041C0700X
Clinical Social Worker
LSWW-1409
WY
1041C0700X
Clinical Social Worker
SW11953
FL
Other
Enumeration date
05/24/2011
Last updated
03/01/2023
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