Provider Demographics
NPI:1265736672
Name:HART, DANI (MS)
Entity type:Individual
Prefix:
First Name:DANI
Middle Name:
Last Name:HART
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:602 LAFAYETTE ST
Mailing Address - Street 2:P.O.BOX 88536
Mailing Address - City:STEILACOOM
Mailing Address - State:WA
Mailing Address - Zip Code:98388-1212
Mailing Address - Country:US
Mailing Address - Phone:253-588-1637
Mailing Address - Fax:
Practice Address - Street 1:602 LAFAYETTE ST
Practice Address - Street 2:
Practice Address - City:STEILACOOM
Practice Address - State:WA
Practice Address - Zip Code:98388-1212
Practice Address - Country:US
Practice Address - Phone:253-588-1637
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-28
Last Update Date:2010-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor