Provider Demographics
NPI:1154756724
Name:HARDNETT, THERESE MARIE
Entity type:Individual
Prefix:
First Name:THERESE
Middle Name:MARIE
Last Name:HARDNETT
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 1:5155 S TORREY PINES DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89118-0649
Mailing Address - Country:US
Mailing Address - Phone:702-771-9304
Mailing Address - Fax:702-998-0552
Practice Address - Street 1:3620 N RANCHO DR STE 113
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89130-3154
Practice Address - Country:US
Practice Address - Phone:702-998-0551
Practice Address - Fax:702-998-0552
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-13
Last Update Date:2013-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner