Provider Demographics
NPI:1356619993
Name:HARDIN-HOWARD, TINA MARIE
Entity type:Individual
Prefix:MISS
First Name:TINA
Middle Name:MARIE
Last Name:HARDIN-HOWARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1455 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89101-1092
Mailing Address - Country:US
Mailing Address - Phone:702-782-7154
Mailing Address - Fax:702-646-7803
Practice Address - Street 1:1455 N MAIN ST
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89101-1092
Practice Address - Country:US
Practice Address - Phone:702-782-7154
Practice Address - Fax:702-646-7803
Is Sole Proprietor?:No
Enumeration Date:2011-12-10
Last Update Date:2011-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator