Provider Demographics
NPI:1851607469
Name:SRAHA, HARRIET (ADMINISTRATOR)
Entity Type:Individual
Prefix:
First Name:HARRIET
Middle Name:
Last Name:SRAHA
Suffix:
Gender:F
Credentials:ADMINISTRATOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5999 STEVENSON AVE
Mailing Address - Street 2:SUITE 401
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22304-3304
Mailing Address - Country:US
Mailing Address - Phone:571-239-8769
Mailing Address - Fax:703-823-0336
Practice Address - Street 1:5999 STEVENSON AVE
Practice Address - Street 2:SIUTE # 401
Practice Address - City:ALEX
Practice Address - State:VA
Practice Address - Zip Code:22304
Practice Address - Country:US
Practice Address - Phone:571-239-8769
Practice Address - Fax:703-823-0336
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-20
Last Update Date:2010-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA100620251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care