Basic Information
| Provider Information | |||||||||
| NPI: | 1255372272 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HARDIGREE | ||||||||
| FirstName: | DEANNE | ||||||||
| MiddleName: | LEE | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | O.T. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2700 10TH S AVE 200 | ||||||||
| Address2: | |||||||||
| City: | BIRMINGHAM | ||||||||
| State: | AL | ||||||||
| PostalCode: | 352051248 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2059337838 | ||||||||
| FaxNumber: | 2056832468 | ||||||||
| Practice Location | |||||||||
| Address1: | 2700 10TH AVE S | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | BIRMINGHAM | ||||||||
| State: | AL | ||||||||
| PostalCode: | 352051200 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2059337838 | ||||||||
| FaxNumber: | 2056832468 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/09/2006 | ||||||||
| LastUpdateDate: | 11/16/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | 0247 | AL | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
ID Information
| ID | Type | State | Issuer | Description | 51524256 | 01 | AL | BCBS | OTHER | 51521667 | 01 | AL | BCBS | OTHER | 51524255 | 01 | AL | BCBS | OTHER | 51529610 | 01 | AL | BCBS | OTHER | 51521451 | 01 | AL | BCBS | OTHER | 51531488 | 01 | AL | BCBS | OTHER |