Healthcare Provider Details

I. General information

NPI: 1952684672
Provider Name (Legal Business Name): CASSANDRA R. HARMON LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2011
Last Update Date: 06/19/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1745 BEAR CORBITT RD 2ND FLOOR
BEAR DE
19701-1528
US

IV. Provider business mailing address

PO BOX 9735
WILMINGTON DE
19809-0735
US

V. Phone/Fax

Practice location:
  • Phone: 888-757-1951
  • Fax: 877-757-1951
Mailing address:
  • Phone: 302-685-9428
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberMT0003131
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: