Provider Demographics
NPI:1437486313
Name:HARDY, LOU ELLEN (MA)
Entity Type:Individual
Prefix:
First Name:LOU
Middle Name:ELLEN
Last Name:HARDY
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 1:2700 N 34TH AVE
Mailing Address - Street 2:UNIT G
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-3144
Mailing Address - Country:US
Mailing Address - Phone:954-894-8974
Mailing Address - Fax:
Practice Address - Street 1:8900 SW 168TH ST
Practice Address - Street 2:
Practice Address - City:PALMETTO BAY
Practice Address - State:FL
Practice Address - Zip Code:33157-4569
Practice Address - Country:US
Practice Address - Phone:305-238-1818
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-12
Last Update Date:2009-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health