Doctor Name: | MR. GARY THOMAS HARDEMAN |
NPI Number: | 1982851812 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.A. |
License Number: | SP3312 |
Business Practice Address: | 346 Kanan Rd #104 Oak Park, CA - 913771100 |
Business Phone Number: | 8189919832 |
Business Fax Number: | 8189916616 |
Mailing Address: | 346 Kanan Rd, #104 OAK PARK |
State: | CA |
Postal Code: | 913771100 |
Phone Number: | 8189919832 |
Fax Number: | |
NPI Enumeration Date: | 08/21/2008 |
NPI Last Update Date: | 08/21/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SP3312 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |