Provider Demographics
NPI:1871955948
Name:HARDY, WHITNEY CLARICE (OTR/L)
Entity type:Individual
Prefix:
First Name:WHITNEY
Middle Name:CLARICE
Last Name:HARDY
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:WHITNEY
Other - Middle Name:
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11119 ST ROMAN WAY
Mailing Address - Street 2:
Mailing Address - City:BONITA SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34135-3112
Mailing Address - Country:US
Mailing Address - Phone:515-210-9091
Mailing Address - Fax:239-643-5908
Practice Address - Street 1:11119 ST ROMAN WAY
Practice Address - Street 2:
Practice Address - City:BONITA SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34135-3112
Practice Address - Country:US
Practice Address - Phone:515-210-9091
Practice Address - Fax:239-643-5908
Is Sole Proprietor?:No
Enumeration Date:2016-03-28
Last Update Date:2020-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL17698225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist