Provider Demographics
NPI:1093936346
Name:HANAN, ROSEMARIE DOROTHY (NCMT)
Entity Type:Individual
Prefix:MS
First Name:ROSEMARIE
Middle Name:DOROTHY
Last Name:HANAN
Suffix:
Gender:F
Credentials:NCMT
Other - Prefix:MS
Other - First Name:ROSE
Other - Middle Name:
Other - Last Name:HANAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NCMT
Mailing Address - Street 1:12732 TAUSTIN LN
Mailing Address - Street 2:
Mailing Address - City:HERNDON
Mailing Address - State:VA
Mailing Address - Zip Code:20170-2978
Mailing Address - Country:US
Mailing Address - Phone:703-318-8351
Mailing Address - Fax:
Practice Address - Street 1:4229 LAFAYETTE CENTER DR
Practice Address - Street 2:SUITE 1900
Practice Address - City:CHANTILLY
Practice Address - State:VA
Practice Address - Zip Code:20151-1209
Practice Address - Country:US
Practice Address - Phone:703-378-2251
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0019002922174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist