Healthcare Provider Details

I. General information

NPI: 1942826193
Provider Name (Legal Business Name): TERRI GRACE SCOTT HARRIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2020
Last Update Date: 01/05/2023
Certification Date: 01/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9413 N 16TH ST
TAMPA FL
33612-8603
US

IV. Provider business mailing address

9413 N 16TH ST
TAMPA FL
33612-8603
US

V. Phone/Fax

Practice location:
  • Phone: 813-400-7225
  • Fax:
Mailing address:
  • Phone: 813-400-7225
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: