Provider Demographics
NPI:1013195676
Name:HARDWICK, DESIREE CAROLINA (OTR/L; NTMTC)
Entity Type:Individual
Prefix:
First Name:DESIREE
Middle Name:CAROLINA
Last Name:HARDWICK
Suffix:
Gender:F
Credentials:OTR/L; NTMTC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13163 HAVERHILL DR
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34609-0643
Mailing Address - Country:US
Mailing Address - Phone:915-253-1691
Mailing Address - Fax:
Practice Address - Street 1:12601 SPRING HILL DR
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34609-5009
Practice Address - Country:US
Practice Address - Phone:352-559-9500
Practice Address - Fax:352-559-0585
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-06
Last Update Date:2022-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT19354225XP0200X, 225XP0200X
OHOT 007043225X00000X, 225XN1300X, 225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XN1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistNeurorehabilitation