Provider Demographics
NPI:1669156139
Name:HARRIMAN, DOROTHY HIMELRIGHT
Entity type:Individual
Prefix:
First Name:DOROTHY
Middle Name:HIMELRIGHT
Last Name:HARRIMAN
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 1:8724 JOHN MARSHALL HWY
Mailing Address - Street 2:
Mailing Address - City:STAR TANNERY
Mailing Address - State:VA
Mailing Address - Zip Code:22654-3009
Mailing Address - Country:US
Mailing Address - Phone:540-409-6470
Mailing Address - Fax:
Practice Address - Street 1:8724 JOHN MARSHALL HWY
Practice Address - Street 2:
Practice Address - City:STAR TANNERY
Practice Address - State:VA
Practice Address - Zip Code:22654-3009
Practice Address - Country:US
Practice Address - Phone:540-409-6470
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-14
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040152351041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical