Provider Demographics
NPI:1134302318
Name:HARDIN, TAMMY INGOLD (MA)
Entity Type:Individual
Prefix:
First Name:TAMMY
Middle Name:INGOLD
Last Name:HARDIN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:915 MEMORIAL CT
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42701-2525
Mailing Address - Country:US
Mailing Address - Phone:270-765-6709
Mailing Address - Fax:270-769-3779
Practice Address - Street 1:915 MEMORIAL CT
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:KY
Practice Address - Zip Code:42701-2525
Practice Address - Country:US
Practice Address - Phone:270-765-6709
Practice Address - Fax:270-769-3779
Is Sole Proprietor?:No
Enumeration Date:2007-12-11
Last Update Date:2007-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY417101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health