Provider Demographics
NPI:1043740160
Name:HARDIMAN, COLLEEN IRENE (MA CCC-SLP)
Entity Type:Individual
Prefix:
First Name:COLLEEN
Middle Name:IRENE
Last Name:HARDIMAN
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 MANCHESTER RD
Mailing Address - Street 2:
Mailing Address - City:FAIRVIEW
Mailing Address - State:PA
Mailing Address - Zip Code:16415-1703
Mailing Address - Country:US
Mailing Address - Phone:814-838-4822
Mailing Address - Fax:
Practice Address - Street 1:900 MANCHESTER RD
Practice Address - Street 2:
Practice Address - City:FAIRVIEW
Practice Address - State:PA
Practice Address - Zip Code:16415-1703
Practice Address - Country:US
Practice Address - Phone:814-838-4822
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-13
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL013423235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist