Provider Demographics
NPI:1720250194
Name:HARDY, KRISTY ANN
Entity Type:Individual
Prefix:MISS
First Name:KRISTY
Middle Name:ANN
Last Name:HARDY
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 1:12 ENGLEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:MA
Mailing Address - Zip Code:02149-5405
Mailing Address - Country:US
Mailing Address - Phone:617-389-3205
Mailing Address - Fax:
Practice Address - Street 1:130 BOYLSTON ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02116-4608
Practice Address - Country:US
Practice Address - Phone:617-450-8140
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-26
Last Update Date:2008-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health