Provider Demographics
NPI:1902636210
Name:HARRISON, DIANNE CATHLEEN
Entity type:Individual
Prefix:
First Name:DIANNE
Middle Name:CATHLEEN
Last Name:HARRISON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:815 PERSHING DR APT 227
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-7442
Mailing Address - Country:US
Mailing Address - Phone:301-910-6750
Mailing Address - Fax:
Practice Address - Street 1:300 T ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-1508
Practice Address - Country:US
Practice Address - Phone:301-257-6585
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-02
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant