Healthcare Provider Details

I. General information

NPI: 1871448910
Provider Name (Legal Business Name): SHANA DANIELLE HARRIS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/03/2026
Last Update Date: 03/03/2026
Certification Date: 03/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 E PRATT ST
BALTIMORE MD
21202-3116
US

IV. Provider business mailing address

9217 LEIGH CHOICE CT
OWINGS MILLS MD
21117-6346
US

V. Phone/Fax

Practice location:
  • Phone: 877-643-8738
  • Fax:
Mailing address:
  • Phone: 443-472-9775
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: