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General NPI Number Information
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NPI Number | 1821621780
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Entity Type | Individual
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Provider Name | NADINE ANA HARTIG PH.D., LPC
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Gender | Female
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Dates
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Enumeration Date | 02/19/2020
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Last Update Date | 03/06/2020
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Provider Practice Location Address
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Address Line | 1028 GROVE AVE APT B
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City | RADFORD
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State | VA
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Zip | 24141-4714
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Country | US
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Telephone | 540-269-6888
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Fax |
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Provider Business Mailing Address
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Address Line | 218 PERSHING AVE
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City | RADFORD
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State | VA
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Zip | 24141-3538
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Country | US
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Telephone | 540-239-5238
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 0701004821
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License Number State | VA
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