Provider Demographics
NPI:1851842132
Name:HARDEMAN, ROSALYN TAYLOR (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ROSALYN
Middle Name:TAYLOR
Last Name:HARDEMAN
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 1:1205 SAN MIGUEL AVE
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93109-2134
Mailing Address - Country:US
Mailing Address - Phone:530-249-1593
Mailing Address - Fax:
Practice Address - Street 1:1205 SAN MIGUEL AVE
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93109-2134
Practice Address - Country:US
Practice Address - Phone:530-249-1593
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-20
Last Update Date:2016-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21270235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist