MEDICARE: MISS SHAQUETTE HARRIS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1104564301
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS SHAQUETTE HARRIS

Provider Business Mailing Address
First Line	:	PO BOX 399318
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94139-9318
Country	:	US
Telephone Number	:	866-523-4268
Fax Number	:

Provider Business Practice Location Address
First Line	:	2018 PRIMARY PARKWAY SUITE 500
Second Line	:
City	:	DULUTH
State	:	GA
Zip	:	30097
Country	:	US
Telephone Number	:	470-363-6756
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/26/2022
Last Update Date	:	05/26/2022

Similar Medicare Providers

1386594836 — PRINCESS SAMARRA WISE APRN, FNP-BC
Practice Location Address:

2730 PEACHTREE INDUSTRIAL BLVD STE 105
DULUTH, GA
30097-8627

Practice Phone: 770-600-2458
Practice Fax: 770-600-2459

1477403970 — ABIGAIL GRACE BRICE
Practice Location Address:

1845 SATELLITE BLVD STE 800
DULUTH, GA
30097-6286

Practice Phone: 404-295-7941
Practice Fax:

1215888995 — CHELSEA BLEDSOE
Practice Location Address:

1845 SATELLITE BLVD
DULUTH, GA
30097-5256

Practice Phone: 404-985-0749
Practice Fax:

1720082084 — DR. LESLIE C GRAY M.D.
Practice Location Address:

9900 MEDLOCK BRIDGE RD
DULUTH, GA
30097-2017

Practice Phone: 770-497-0699
Practice Fax: 770-497-0388

1316944671 — DR. WILLIAM MONEIT
Practice Location Address:

2925 PREMIERE PKWY , SUITE #140
DULUTH, GA
30097

Practice Phone: 770-495-6222
Practice Fax: 770-495-9959

1174510036 — MS. LISA M FOREMAN NP-C
Practice Location Address:

9900 MEDLOCK BRIDGE RD
DULUTH, GA
30097-2017

Practice Phone: 770-497-0699
Practice Fax: 770-497-0388

1396732269 — MRS. TIFFINY B COHEN PA-C
Practice Location Address:

10700 MEDLOCK BRIDGE RD , SUITE 102
DULUTH, GA
30097-8456

Practice Phone: 770-497-0699
Practice Fax: 770-497-0388

Directions to “ MISS SHAQUETTE HARRIS ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.