Doctor Name: | DAVINA HARDIN |
NPI Number: | 1174823850 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PSYD |
License Number: | |
Business Practice Address: | 2000 Commerce Dr West Melbourne, FL - 329042335 |
Business Phone Number: | 3217225200 |
Business Fax Number: | |
Mailing Address: | 2000 Commerce Dr, WEST MELBOURNE |
State: | FL |
Postal Code: | 329042335 |
Phone Number: | 3217225200 |
Fax Number: | |
NPI Enumeration Date: | 10/27/2010 |
NPI Last Update Date: | 10/12/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC1900X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Counseling |
Taxonomy Definition: |