Healthcare Provider Details

I. General information

NPI: 1699687285
Provider Name (Legal Business Name): LASHANDRALYN HARRISON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/19/2026
Last Update Date: 09/19/2026
Certification Date: 09/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5750 GENESIS CT STE 205
FRISCO TX
75034-4284
US

IV. Provider business mailing address

5750 GENESIS CT STE 205
FRISCO TX
75034-4284
US

V. Phone/Fax

Practice location:
  • Phone: 972-292-9534
  • Fax:
Mailing address:
  • Phone: 972-292-9534
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number102112
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: