Provider Demographics
NPI:1881170637
Name:HARBISON, LIZA
Entity type:Individual
Prefix:
First Name:LIZA
Middle Name:
Last Name:HARBISON
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 1:305 WHITTIER ST NW APT 202
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20012-2751
Mailing Address - Country:US
Mailing Address - Phone:301-661-6370
Mailing Address - Fax:
Practice Address - Street 1:8894 STANFORD BLVD STE 103
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-5161
Practice Address - Country:US
Practice Address - Phone:410-440-1413
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-16
Last Update Date:2018-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty