Provider Demographics
NPI:1609043322
Name:HARDY, TIA MONEE'
Entity Type:Individual
Prefix:
First Name:TIA
Middle Name:MONEE'
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 1:4077 WYNDYBROW DR
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:VA
Mailing Address - Zip Code:23703-2053
Mailing Address - Country:US
Mailing Address - Phone:757-967-9596
Mailing Address - Fax:
Practice Address - Street 1:4077 WYNDYBROW DR
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23703-2053
Practice Address - Country:US
Practice Address - Phone:757-967-9596
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-12
Last Update Date:2008-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247000000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Health Information