Healthcare Provider Details

I. General information

NPI: 1417810904
Provider Name (Legal Business Name): HANNAH ANDERSON HARRIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/03/2025
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6655 QUINCE RD STE 101
MEMPHIS TN
38119-8031
US

IV. Provider business mailing address

PO BOX 360595
PITTSBURGH PA
15251-6595
US

V. Phone/Fax

Practice location:
  • Phone: 901-567-5361
  • Fax: 901-321-5257
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number2052
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: