Provider Demographics
NPI:1508892662
Name:HARTWICH, VIRGINIA MARIE (MSW)
Entity Type:Individual
Prefix:MS
First Name:VIRGINIA
Middle Name:MARIE
Last Name:HARTWICH
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:812 SILVERWOOD DR
Mailing Address - Street 2:
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746-4950
Mailing Address - Country:US
Mailing Address - Phone:407-599-1350
Mailing Address - Fax:407-599-1389
Practice Address - Street 1:5201 RAYMOND ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-8208
Practice Address - Country:US
Practice Address - Phone:407-599-1350
Practice Address - Fax:407-599-1389
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC000313001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical