Provider Demographics
NPI:1306049556
Name:HARDIN, CHRISTINA MARY (LLP)
Entity type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:MARY
Last Name:HARDIN
Suffix:
Gender:F
Credentials:LLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:630 S ORANGE AVE
Mailing Address - Street 2:SUITE 200K
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34236-7504
Mailing Address - Country:US
Mailing Address - Phone:941-301-8420
Mailing Address - Fax:
Practice Address - Street 1:630 S ORANGE AVE
Practice Address - Street 2:SUITE 200K
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34236-7504
Practice Address - Country:US
Practice Address - Phone:941-301-8420
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-06
Last Update Date:2012-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301012650103T00000X
FLPMH1056101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103T00000XBehavioral Health & Social Service ProvidersPsychologist