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General NPI Number Information
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NPI Number | 1295716009
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Entity Type | Individual
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Provider Name | ANITA DIANNE HARRISON LCSW
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Gender | Female
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Dates
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Enumeration Date | 11/09/2005
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Last Update Date | 05/26/2008
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Provider Practice Location Address
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Address Line | 4914 RADFORD AVE STE 207
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City | RICHMOND
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State | VA
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Zip | 23230-3538
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Country | US
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Telephone | 804-688-0225
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Fax | 804-355-0225
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Provider Business Mailing Address
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Address Line | PO BOX 35395 RESOURCE GUIDANCE SERVICES INC
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City | RICHMOND
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State | VA
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Zip | 23235-0395
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Country | US
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Telephone | 804-378-3364
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Fax | 804-378-2078
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 0904002774
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License Number State | VA
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