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NPI 1174662688

NPI 1174662688 : DIANNA HACK HART LCSW : SPOTSYLVANIA, VA

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General NPI Number Information
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    NPI Number           |    1174662688
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    Entity Type          |    Individual 
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    Provider Name        |    DIANNA HACK HART LCSW
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    02/05/2007
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    Last Update Date     |    07/06/2012
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Provider Practice Location Address
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    Address Line         |    8915 MILLWOOD DR 
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    City                 |    SPOTSYLVANIA
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    State                |    VA
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    Zip                  |    22551-3320
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    Country              |    US
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    Telephone            |    540-226-3061
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    PO BOX 1797 
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    City                 |    SPOTSYLVANIA
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    State                |    VA
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    Zip                  |    22553-6797
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    Country              |    US
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    Telephone            |    540-226-3061
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    1041C0700X
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    Taxonomy Name        |    Clinical Social Worker
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    License Number       |    0904006275
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    License Number State |    VA
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