Provider Demographics
NPI:1851795579
Name:HARDIN, CHRISTINE (MT-BC, WMTR)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:HARDIN
Suffix:
Gender:F
Credentials:MT-BC, WMTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1031 N EDGE TRL
Mailing Address - Street 2:
Mailing Address - City:VERONA
Mailing Address - State:WI
Mailing Address - Zip Code:53593-1942
Mailing Address - Country:US
Mailing Address - Phone:608-848-2045
Mailing Address - Fax:
Practice Address - Street 1:1031 N EDGE TRL
Practice Address - Street 2:
Practice Address - City:VERONA
Practice Address - State:WI
Practice Address - Zip Code:53593-1942
Practice Address - Country:US
Practice Address - Phone:608-848-2045
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-09
Last Update Date:2014-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI122-38225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist