Healthcare Provider Details

I. General information

NPI: 1447164991
Provider Name (Legal Business Name): ABBY N HARRIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

208 CORPORATE DR
CARROLLTON GA
30117-2466
US

IV. Provider business mailing address

535 COUNTRY BREEZE CIR
WEDOWEE AL
36278-5754
US

V. Phone/Fax

Practice location:
  • Phone: 833-322-3423
  • Fax:
Mailing address:
  • Phone: 931-561-4349
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number23-283286
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: