Provider Demographics
NPI:1346659240
Name:HARDY, TANYA
Entity Type:Individual
Prefix:
First Name:TANYA
Middle Name:
Last Name:HARDY
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 1:5830 MOUNT MORIAH RD
Mailing Address - Street 2:STE 20
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38115-1607
Mailing Address - Country:US
Mailing Address - Phone:901-244-6182
Mailing Address - Fax:901-244-6258
Practice Address - Street 1:5830 MOUNT MORIAH RD
Practice Address - Street 2:STE 20
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38115-1607
Practice Address - Country:US
Practice Address - Phone:901-244-6182
Practice Address - Fax:901-244-6258
Is Sole Proprietor?:No
Enumeration Date:2014-08-05
Last Update Date:2014-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health