Provider Demographics
NPI:1013396761
Name:KARDINSMITH, SOLEDAD
Entity Type:Individual
Prefix:
First Name:SOLEDAD
Middle Name:
Last Name:KARDINSMITH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 FARABEE DR N
Mailing Address - Street 2:SUITE C
Mailing Address - City:LAFAYETTE
Mailing Address - State:IN
Mailing Address - Zip Code:47905-5913
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:115 FARABEE DR N
Practice Address - Street 2:SUITE C
Practice Address - City:LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47905-5913
Practice Address - Country:US
Practice Address - Phone:765-588-7763
Practice Address - Fax:765-423-5600
Is Sole Proprietor?:No
Enumeration Date:2015-05-27
Last Update Date:2015-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical