Healthcare Provider Details

I. General information

NPI: 1851055099
Provider Name (Legal Business Name): RON'NISHA HARRIS BCBA, LBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/25/2021
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

276 MEDICAL WAY
RIVERDALE GA
30274-2521
US

IV. Provider business mailing address

2050 CHESHIRE BRIDGE RD NE UNIT 1501
ATLANTA GA
30324-4360
US

V. Phone/Fax

Practice location:
  • Phone: 404-726-3426
  • Fax:
Mailing address:
  • Phone: 770-598-9989
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-26-2833743
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: