Provider Demographics
NPI:1902991524
Name:HARDY, TIFFANY JOSEPH (MDIV)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:JOSEPH
Last Name:HARDY
Suffix:
Gender:M
Credentials:MDIV
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5500 ARMSTRONG RD.
Mailing Address - Street 2:BATTLE CREEK VAMC
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49015
Mailing Address - Country:US
Mailing Address - Phone:269-966-5600
Mailing Address - Fax:269-660-5008
Practice Address - Street 1:5500 ARMSTRONG RD.
Practice Address - Street 2:BATTLE CREEK VAMC
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49015
Practice Address - Country:US
Practice Address - Phone:269-966-5600
Practice Address - Fax:269-660-5008
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral