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General NPI Number Information
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NPI Number | 1003810615
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Entity Type | Individual
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Provider Name | BEVERLY ANN HARRIS CEO
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Gender | Female
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Dates
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Enumeration Date | 06/10/2005
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Last Update Date | 10/01/2025
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Provider Practice Location Address
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Address Line | 7703 ROYSTON ST
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City | ANNANDALE
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State | VA
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Zip | 22003-5332
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Country | US
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Telephone | 571-346-2437
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Fax |
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Provider Business Mailing Address
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Address Line | 5510 CHEROKEE AVE
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City | ALEXANDRIA
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State | VA
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Zip | 22312-2320
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Country | US
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Telephone | 571-346-2437
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number |
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 1744R1103X
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Taxonomy Name | Research Study Abstracter/Coder
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State | VA
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Taxonomy #4
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State | MD
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