Provider Demographics
NPI:1811565682
Name:HARDY, MELISSA J (MASTERS OF EDUCATION)
Entity Type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:J
Last Name:HARDY
Suffix:
Gender:F
Credentials:MASTERS OF EDUCATION
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:535 SAUDERS RD SE
Mailing Address - Street 2:
Mailing Address - City:PALM BAY
Mailing Address - State:FL
Mailing Address - Zip Code:32909-6647
Mailing Address - Country:US
Mailing Address - Phone:321-914-5649
Mailing Address - Fax:
Practice Address - Street 1:535 SAUDERS RD SE
Practice Address - Street 2:
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32909-6647
Practice Address - Country:US
Practice Address - Phone:321-914-5649
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-16
Last Update Date:2021-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist