Provider Demographics
NPI:1740409382
Name:HARROW, MITCHELL SCOTT (PH D)
Entity type:Individual
Prefix:DR
First Name:MITCHELL
Middle Name:SCOTT
Last Name:HARROW
Suffix:
Gender:M
Credentials:PH D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13523 FALLEN OAK CT
Mailing Address - Street 2:
Mailing Address - City:CHANTILLY
Mailing Address - State:VA
Mailing Address - Zip Code:20151-2427
Mailing Address - Country:US
Mailing Address - Phone:703-378-9667
Mailing Address - Fax:
Practice Address - Street 1:8320 PROFESSIONAL HILL DR
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-4611
Practice Address - Country:US
Practice Address - Phone:703-876-8480
Practice Address - Fax:703-876-8482
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810001678103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical