Provider Demographics
NPI:1750609467
Name:HARWOOD, ALISHSA (LMT)
Entity type:Individual
Prefix:
First Name:ALISHSA
Middle Name:
Last Name:HARWOOD
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7862 KINGLAND DR
Mailing Address - Street 2:STE 201
Mailing Address - City:WEST CHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45069-2573
Mailing Address - Country:US
Mailing Address - Phone:513-755-1341
Mailing Address - Fax:513-755-5342
Practice Address - Street 1:7862 KINGLAND DR
Practice Address - Street 2:STE 201
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45069-2573
Practice Address - Country:US
Practice Address - Phone:513-755-1341
Practice Address - Fax:513-755-5342
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-06
Last Update Date:2010-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH17144171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH311630602OtherTIN