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General NPI Number Information
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NPI Number | 1730802646
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Entity Type | Individual
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Provider Name | MARQUITA LA MOR PINKETT-HARRIS PTA
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Gender | Female
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Dates
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Enumeration Date | 09/26/2022
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Last Update Date | 09/26/2022
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Provider Practice Location Address
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Address Line | 1601 KIRKWOOD HWY
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City | WILMINGTON
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State | DE
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Zip | 19805-4917
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Country | US
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Telephone | 267-469-5557
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Fax |
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Provider Business Mailing Address
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Address Line | 8 BRIAR CT
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City | MILFORD
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State | DE
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Zip | 19963-3900
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Country | US
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Telephone | 360-265-0890
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | J2-0000920
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License Number State | DE
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