Provider Demographics
NPI:1851863823
Name:HARDY, BRIGETTE (OTR/L)
Entity Type:Individual
Prefix:
First Name:BRIGETTE
Middle Name:
Last Name:HARDY
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12407 SHEPPARD WAY
Mailing Address - Street 2:
Mailing Address - City:WALTON
Mailing Address - State:KY
Mailing Address - Zip Code:41094-7835
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8520 GUNPOWDER RD
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-2450
Practice Address - Country:US
Practice Address - Phone:859-568-3192
Practice Address - Fax:839-218-5796
Is Sole Proprietor?:No
Enumeration Date:2019-01-01
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOT009079225X00000X
KY165381225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist