Provider Demographics
NPI:1942832928
Name:HARDAGE, REAGAN L (MS, OTR/L)
Entity type:Individual
Prefix:
First Name:REAGAN
Middle Name:L
Last Name:HARDAGE
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:REAGAN
Other - Middle Name:L
Other - Last Name:PARSONS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:105 GRAND RIDGE TER
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71901-9219
Mailing Address - Country:US
Mailing Address - Phone:501-701-4348
Mailing Address - Fax:
Practice Address - Street 1:105 GRAND RIDGE TER
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71901-9219
Practice Address - Country:US
Practice Address - Phone:501-701-4348
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-07
Last Update Date:2020-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AROTR3189225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist