Provider Demographics
NPI:1972035525
Name:BARDIN, MARY ELIZABETH
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:ELIZABETH
Last Name:BARDIN
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 1:3540 NC HWY 22 S
Mailing Address - Street 2:
Mailing Address - City:RAMSEUR
Mailing Address - State:NC
Mailing Address - Zip Code:27316-8519
Mailing Address - Country:US
Mailing Address - Phone:336-265-7853
Mailing Address - Fax:336-450-1924
Practice Address - Street 1:3540 NC HWY 22 S
Practice Address - Street 2:
Practice Address - City:RAMSEUR
Practice Address - State:NC
Practice Address - Zip Code:27316-8519
Practice Address - Country:US
Practice Address - Phone:336-265-7853
Practice Address - Fax:336-450-1924
Is Sole Proprietor?:No
Enumeration Date:2017-04-03
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist