Healthcare Provider Details

I. General information

NPI: 1023824349
Provider Name (Legal Business Name): TONISHA HARRIS DSP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/10/2024
Last Update Date: 12/10/2024
Certification Date: 12/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1728 ADAMS RD
CINCINNATI OH
45231-3135
US

IV. Provider business mailing address

4616 BUCKSKIN TRL
CINCINNATI OH
45245-1247
US

V. Phone/Fax

Practice location:
  • Phone: 419-612-3866
  • Fax:
Mailing address:
  • Phone: 419-612-3866
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: