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General NPI Number Information
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NPI Number | 1134889504
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Entity Type | Individual
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Provider Name | JANEA HARRIS
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Gender | Female
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Dates
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Enumeration Date | 12/27/2021
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Last Update Date | 12/27/2021
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Provider Practice Location Address
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Address Line | 2585 CHIPPING CT
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City | VILLA RICA
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State | GA
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Zip | 30180-5839
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Country | US
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Telephone | 770-568-8138
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 571
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City | VILLA RICA
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State | GA
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Zip | 30180-0571
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Country | US
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Telephone | 177-056-8813
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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 | 225600000X
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Taxonomy Name | Dance Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225800000X
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Taxonomy Name | Recreation Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 225A00000X
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Taxonomy Name | Music Therapist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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