Provider Demographics
NPI:1073972402
Name:HARDYMAN, CAROLINE M (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:M
Last Name:HARDYMAN
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 PLYMOUTH RD
Mailing Address - Street 2:SUITE 220
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55305-2366
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2000 PLYMOUTH RD
Practice Address - Street 2:SUITE 220
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55305-2366
Practice Address - Country:US
Practice Address - Phone:952-223-2506
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-13
Last Update Date:2016-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN9434235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist