Provider Demographics
NPI:1255372272
Name:HARDIGREE, DEANNE LEE (OT)
Entity type:Individual
Prefix:MS
First Name:DEANNE
Middle Name:LEE
Last Name:HARDIGREE
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2700 10TH S AVE 200
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35205-1248
Mailing Address - Country:US
Mailing Address - Phone:205-933-7838
Mailing Address - Fax:205-683-2468
Practice Address - Street 1:2700 10TH AVE S
Practice Address - Street 2:SUITE 200
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35205-1200
Practice Address - Country:US
Practice Address - Phone:205-933-7838
Practice Address - Fax:205-683-2468
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2015-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL0247225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51524256OtherBCBS
AL51521667OtherBCBS
AL51524255OtherBCBS
AL51529610OtherBCBS
AL51521451OtherBCBS
AL51531488OtherBCBS
AL51524255OtherBCBS
07712Medicare UPIN