Provider Demographics
NPI:1649243452
Name:HARDIN, KATHRYN MORTON (MS, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:KATHRYN
Middle Name:MORTON
Last Name:HARDIN
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:718 W TRADE ST
Mailing Address - Street 2:STE 514
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28202-1339
Mailing Address - Country:US
Mailing Address - Phone:704-370-2767
Mailing Address - Fax:704-370-2926
Practice Address - Street 1:718 W TRADE ST
Practice Address - Street 2:STE 514
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28202-1339
Practice Address - Country:US
Practice Address - Phone:704-370-2767
Practice Address - Fax:704-370-2926
Is Sole Proprietor?:No
Enumeration Date:2006-02-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6798235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7412341Medicaid