Provider Demographics
NPI:1912781394
Name:HARDIN, GRACE NICOLE
Entity Type:Individual
Prefix:MRS
First Name:GRACE
Middle Name:NICOLE
Last Name:HARDIN
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 1:446 NE BURGESS PL
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-5065
Mailing Address - Country:US
Mailing Address - Phone:541-633-6397
Mailing Address - Fax:
Practice Address - Street 1:446 NE BURGESS PL
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-5065
Practice Address - Country:US
Practice Address - Phone:541-633-6397
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-24
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker