| Doctor Name: | HENRY D HARDT |
| NPI Number: | 1033109442 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PH.D. |
| License Number: | 865 |
| Business Practice Address: | 4555 Lake Shore Dr Waco, TX - 767101814 |
| Business Phone Number: | 2547760400 |
| Business Fax Number: | 2547760637 |
| Mailing Address: | 4555 Lake Shore Dr, WACO |
| State: | TX |
| Postal Code: | 767101814 |
| Phone Number: | 2547760400 |
| Fax Number: | 2547760637 |
| NPI Enumeration Date: | 10/26/2005 |
| NPI Last Update Date: | 10/10/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 865 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | TX |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |