Individual
MS. ANNETTA HARDIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4615 W LAWRENCE LN, GLENDALE, AZ 85302-5229
(623) 334-5203
Mailing address
4615 W LAWRENCE LN, GLENDALE, AZ 85302-5229
(623) 334-5203
Taxonomy
Speciality
Code
Description
License number
State
385HR2055X
Child Mental Illness Respite Care
Primary
11688
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
132419
AHCCCS ID NUMBER
AZ
Enumeration date
11/27/2006
Last updated
02/10/2009
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