Provider Demographics
NPI:1114356334
Name:HARDY, TAMIKA (DPT)
Entity Type:Individual
Prefix:
First Name:TAMIKA
Middle Name:
Last Name:HARDY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4321 HARTWICK RD
Mailing Address - Street 2:101
Mailing Address - City:COLLEGE PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20740-3210
Mailing Address - Country:US
Mailing Address - Phone:301-277-6616
Mailing Address - Fax:301-277-6618
Practice Address - Street 1:4321 HARTWICK RD
Practice Address - Street 2:101
Practice Address - City:COLLEGE PARK
Practice Address - State:MD
Practice Address - Zip Code:20740-3210
Practice Address - Country:US
Practice Address - Phone:301-277-6616
Practice Address - Fax:301-277-6618
Is Sole Proprietor?:No
Enumeration Date:2013-11-07
Last Update Date:2013-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD247632251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic