Provider Demographics
NPI:1922231760
Name:HARDENBURG, STEPHANIE A (PHD)
Entity type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:A
Last Name:HARDENBURG
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1308 DEVILS REACH RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22192
Mailing Address - Country:US
Mailing Address - Phone:703-492-2994
Mailing Address - Fax:703-490-5505
Practice Address - Street 1:1308 DEVILS REACH RD
Practice Address - Street 2:#300
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22192
Practice Address - Country:US
Practice Address - Phone:703-492-2994
Practice Address - Fax:703-490-5505
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-27
Last Update Date:2009-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist