Individual
MISS STACIE MICHELLE HARDIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
801 S STATE ROAD 57, WASHINGTON, IN 47501-4373
(812) 254-4516
Mailing address
8120 LINCOLN AVE APT C, EVANSVILLE, IN 47715-7232
(812) 303-0069
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
32001733A
IN
Other
Enumeration date
03/29/2010
Last updated
03/29/2010
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