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General NPI Number Information
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NPI Number | 1114523388
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Entity Type | Individual
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Provider Name | ARIEL MONIQUE HARRIS
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Gender | Female
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Dates
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Enumeration Date | 12/11/2020
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Last Update Date | 12/11/2020
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Provider Practice Location Address
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Address Line | 1030 FOREST STREET
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City | MELVILLE
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State | LA
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Zip | 71353
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Country | US
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Telephone | 337-412-0366
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Fax |
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Provider Business Mailing Address
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Address Line | 312 SIDNEY MARTIN RD
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City | LAFAYETTE
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State | LA
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Zip | 70507-4518
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Country | US
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Telephone | 337-412-0366
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171WV0202X
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Taxonomy Name | Vehicle Modifications Contractor
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License Number |
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License Number State |
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