Individual
MRS. SAMANTHA LYNN HARDESTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A., BCBA
Contact information
Practice address
2126 E BALTIMORE ST, BALTIMORE, MD 21231-2041
(804) 519-1360
Mailing address
2126 E BALTIMORE ST, BALTIMORE, MD 21231-2041
(804) 519-1360
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-08-4368
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5463050-00
—
MD
Enumeration date
09/19/2013
Last updated
09/19/2013
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