Healthcare Provider Details

I. General information

NPI: 1275592297
Provider Name (Legal Business Name): DANA L HUARD LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2025 WOODBROOK CT
CHARLOTTESVILLE VA
22901-1148
US

IV. Provider business mailing address

2025 WOODBROOK CT
CHARLOTTESVILLE VA
22901-1148
US

V. Phone/Fax

Practice location:
  • Phone: 434-973-6575
  • Fax: 434-973-2333
Mailing address:
  • Phone: 434-973-6575
  • Fax: 434-973-2333

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0701002920
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: