Healthcare Provider Details

I. General information

NPI: 1083581474
Provider Name (Legal Business Name): ALESHA STONE HARRIS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/20/2025
Last Update Date: 10/20/2025
Certification Date: 10/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

204 WOODLAWN HTS
CHATHAM VA
24531-5549
US

IV. Provider business mailing address

204 WOODLAWN HTS
CHATHAM VA
24531-5549
US

V. Phone/Fax

Practice location:
  • Phone: 434-247-2240
  • Fax:
Mailing address:
  • Phone: 434-247-2240
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172A00000X
TaxonomyDriver
License NumberT60299936
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: