Healthcare Provider Details

I. General information

NPI: 1891523049
Provider Name (Legal Business Name): RONA HARRIS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/22/2024
Last Update Date: 07/22/2024
Certification Date: 07/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 S BRADFORD ST
DOVER DE
19904-4153
US

IV. Provider business mailing address

459 PHOENIX DR
DOVER DE
19901-2205
US

V. Phone/Fax

Practice location:
  • Phone: 302-264-9436
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberQ4-0010154
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: