Provider Demographics
NPI:1336877166
Name:HARDY, ADRIENNE
Entity Type:Individual
Prefix:
First Name:ADRIENNE
Middle Name:
Last Name:HARDY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ADRIENNE
Other - Middle Name:FRANCES
Other - Last Name:WHEATON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1747 BUSHVILLE HWY LOT 26
Mailing Address - Street 2:
Mailing Address - City:ARNAUDVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70512-4100
Mailing Address - Country:US
Mailing Address - Phone:337-945-3431
Mailing Address - Fax:
Practice Address - Street 1:2397 CECILIA SR HIGH SCHOOL HWY
Practice Address - Street 2:
Practice Address - City:BREAUX BRIDGE
Practice Address - State:LA
Practice Address - Zip Code:70517-6830
Practice Address - Country:US
Practice Address - Phone:337-909-3500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-10
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA8584235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist