Provider Demographics
NPI:1598890568
Name:HARDEL, JENNIFER ARANT (LOTR)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:ARANT
Last Name:HARDEL
Suffix:
Gender:F
Credentials:LOTR
Other - Prefix:MRS
Other - First Name:JENNIFER
Other - Middle Name:MULFORD
Other - Last Name:ARANT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9625 SMITHERMAN DR
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71115-2916
Mailing Address - Country:US
Mailing Address - Phone:318-797-5978
Mailing Address - Fax:
Practice Address - Street 1:2205 E 70TH ST
Practice Address - Street 2:SUITE 102
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71105-5308
Practice Address - Country:US
Practice Address - Phone:318-795-3388
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-22
Last Update Date:2017-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAZ11264225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist