Provider Demographics
NPI:1114687597
Name:HARDIN, CHEMIKA
Entity Type:Individual
Prefix:
First Name:CHEMIKA
Middle Name:
Last Name:HARDIN
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 1:225 CEDAR HILL STREET
Mailing Address - Street 2:200
Mailing Address - City:MARLBROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01752
Mailing Address - Country:US
Mailing Address - Phone:404-414-7377
Mailing Address - Fax:
Practice Address - Street 1:225 CEDAR HILL STREET
Practice Address - Street 2:200
Practice Address - City:MARLBROUGH
Practice Address - State:MA
Practice Address - Zip Code:01752
Practice Address - Country:US
Practice Address - Phone:404-414-7377
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-27
Last Update Date:2021-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician