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General NPI Number Information
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NPI Number | 1235795055
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Entity Type | Individual
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Provider Name | DANA KHADIJA HARMON PHD, MSW, LICSW
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Gender | Female
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Dates
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Enumeration Date | 05/16/2019
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Last Update Date | 05/16/2019
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Provider Practice Location Address
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Address Line | 4131 CARMICHAEL RD STE 9
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City | MONTGOMERY
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State | AL
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Zip | 36106-2801
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Country | US
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Telephone | 334-318-1584
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Fax | 334-649-4099
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Provider Business Mailing Address
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Address Line | PO BOX 240912
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City | MONTGOMERY
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State | AL
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Zip | 36124-0912
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Country | US
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Telephone | 334-318-1584
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Fax | 334-649-4099
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 3978C
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License Number State | AL
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