Provider Demographics
NPI:1023569514
Name:HARDISON, SADIE COLEMAN (AUD)
Entity type:Individual
Prefix:DR
First Name:SADIE
Middle Name:COLEMAN
Last Name:HARDISON
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:SADIE
Other - Middle Name:BRIGHT
Other - Last Name:COLEMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:PO BOX 68
Mailing Address - Street 2:
Mailing Address - City:POLLOCKSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28573-0068
Mailing Address - Country:US
Mailing Address - Phone:910-219-8080
Mailing Address - Fax:910-219-8128
Practice Address - Street 1:241 FREEDOM WAY
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28544-1418
Practice Address - Country:US
Practice Address - Phone:910-219-8080
Practice Address - Fax:910-219-8128
Is Sole Proprietor?:No
Enumeration Date:2016-10-19
Last Update Date:2020-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY 2090231H00000X
NC12407235Z00000X, 231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist