| Doctor Name: | MRS. VIDA HARTZ |
| NPI Number: | 1538493366 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MA, LLPC, NCC |
| License Number: | 6401010571 |
| Business Practice Address: | 6130 Cochise Dr West Bloomfield, MI - 483222361 |
| Business Phone Number: | 2487525080 |
| Business Fax Number: | |
| Mailing Address: | 3894 Teakwood Ln, ROCHESTER HILLS |
| State: | MI |
| Postal Code: | 483091049 |
| Phone Number: | 2487656157 |
| Fax Number: | 2482760677 |
| NPI Enumeration Date: | 09/27/2009 |
| NPI Last Update Date: | 09/27/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101Y00000X |
| License Number: | 6401010571 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |