Provider Demographics
NPI:1962861831
Name:HANRAHAN, DOROTHY ELIZABETH (MS, RD)
Entity Type:Individual
Prefix:
First Name:DOROTHY
Middle Name:ELIZABETH
Last Name:HANRAHAN
Suffix:
Gender:F
Credentials:MS, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 S 10TH ST
Mailing Address - Street 2:APARTMENT I
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19147-1252
Mailing Address - Country:US
Mailing Address - Phone:610-308-9628
Mailing Address - Fax:
Practice Address - Street 1:505 S 10TH ST
Practice Address - Street 2:APARTMENT I
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19147-1252
Practice Address - Country:US
Practice Address - Phone:610-308-9628
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-19
Last Update Date:2016-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA86036751133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered