Individual
DANIELLE M HARTLEBEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CSAC
Contact information
Practice address
109 WIMBLEDON SQ STE H, CHESAPEAKE, VA 23320-4945
(757) 410-8244
Mailing address
109 WIMBLEDON SQ STE H, CHESAPEAKE, VA 23320-4945
(757) 410-8244
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
071010980
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00
N/A
VA
Enumeration date
12/10/2018
Last updated
12/10/2018
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