Provider Demographics
NPI:1205489093
Name:HARRINGTON, DYLANA (PTA)
Entity type:Individual
Prefix:
First Name:DYLANA
Middle Name:
Last Name:HARRINGTON
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4410 BREEZY BAY CIR APT 202
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23233-7116
Mailing Address - Country:US
Mailing Address - Phone:252-799-6232
Mailing Address - Fax:
Practice Address - Street 1:4410 BREEZY BAY CIR APT 202
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23233-7116
Practice Address - Country:US
Practice Address - Phone:252-799-6232
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-20
Last Update Date:2019-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2306605362225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant