Individual
LYDIA HARRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
HOMECARE PROVIDER
Contact information
Practice address
5901 KINGSTOWNE VILLAGE PKWY STE 201, ALEXANDRIA, VA 22315-5882
(703) 718-3551
(703) 417-9931
Mailing address
5901 KINGSTOWNE VILLAGE PKWY STE 201, ALEXANDRIA, VA 22315-5882
(703) 718-3551
(703) 417-9931
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
HCO-212420
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1962037838
—
VA
Enumeration date
11/04/2022
Last updated
11/04/2022
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