Individual
AMANDA HARDWICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
120 PONDEROSA DR STE D, CHRISTIANSBURG, VA 24073-6599
(540) 268-0539
(540) 268-0050
Mailing address
120 PONDEROSA DR STE D, CHRISTIANSBURG, VA 24073-6599
(540) 268-0539
(540) 268-0050
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
601077182
—
VA
01
—
Q52547F511
MEDICARE PTAN
VA
Enumeration date
01/14/2015
Last updated
08/13/2019
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