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Individual
FANTA HARDWELL
Active
Individual
FANTA HARDWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
13706
TX
1041C0700X
Clinical Social Worker
Primary
109422
TX
Other
Enumeration date
11/09/2020
Last updated
10/31/2025
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