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NPI Code Detail

MEDICARE: RONISHA JANICE HARRELL

MEDICARE: RONISHA JANICE HARRELL
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
1103TH0004XHealth PsychologistLA

General Provider Information

NPI Number : 1720811128
Entity Type Code : Individual
Provider Name (Legal Business Name) : RONISHA JANICE HARRELL
Provider Business Mailing Address
First Line : 221 ACADIA DR
Second Line :
City : WESTWEGO
State : LA
Zip : 70094-2143
Country : US
Telephone Number : 504-722-0619
Fax Number :
Provider Business Practice Location Address
First Line : 3014 DAUPHINE ST
Second Line :
City : NEW ORLEANS
State : LA
Zip : 70117-6754
Country : US
Telephone Number : 504-722-0619
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/21/2024
Last Update Date : 08/21/2024

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Directions to “ RONISHA JANICE HARRELL ” Practice Location

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