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Individual

HENRY D HARDT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
4555 LAKE SHORE DR, WACO, TX 76710-1814
(254) 776-0400
(254) 776-0637
Mailing address
4555 LAKE SHORE DR, WACO, TX 76710-1814
(254) 776-0400
(254) 776-0637

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
865
TX
103T00000X
Psychologist
Primary
20734
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
033135701
TX
Enumeration date
10/26/2005
Last updated
10/10/2012
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