Dejon Harris

Individual provider Active NPI Counselor · South Chesterfield, VA

NPI 1023529682 · NPPES record last updated Oct 22, 2017

Key facts

NPI
1023529682
Entity type
Individual (NPI type 1)
Primary specialty
Counselor 101Y00000X
Practice address
20012 Loyal Ave
South Chesterfield, VA 23803-1622
Phone
(804) 210-0990
NPI assigned
Oct 22, 2017
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X VA Yes

Addresses

Primary practice location

20012 Loyal Ave
South Chesterfield, VA 23803-1622

Mailing address

20012 Loyal Ave
South Chesterfield, VA 23803-1622

Other providers in South Chesterfield, VA

All providers in South Chesterfield, VA · Counselor in Virginia

Sources for this page

Verify at the official NPI Registry.