Provider Demographics
NPI:1518202571
Name:PHARR, DANA R
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:R
Last Name:PHARR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4451 DON TOMASO DR
Mailing Address - Street 2:APT. 3
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90008-4164
Mailing Address - Country:US
Mailing Address - Phone:323-321-1825
Mailing Address - Fax:
Practice Address - Street 1:6303 OWENSMOUTH AVE. FL 10
Practice Address - Street 2:DIRECT ED SPECIALIZED SERVICES LLC
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91367
Practice Address - Country:US
Practice Address - Phone:323-391-1622
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-03
Last Update Date:2012-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19002355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant