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General NPI Number Information
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NPI Number | 1205791845
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Entity Type | Organization
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Legal Business Name | ELEANOR HEALTH PROFESSIONAL TX, PLLC
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Dates
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Enumeration Date | 12/17/2025
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Last Update Date | 12/17/2025
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Provider Practice Location Address
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Address Line | 250 E 200 S SUITE 1600, OFFICE NO. 1535
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City | SALT LAKE CITY
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State | UT
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Zip | 84111
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Country | US
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Telephone | 781-487-1107
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 386
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City | PORTSMOUTH
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State | NH
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Zip | 03802-0386
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Country | US
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Telephone | 781-487-1107
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Fax |
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Authorized Official
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Title or Position | OWNER/FOUNDER
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Name | NZINGA AJABU HARRISON
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Credential | MD
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Telephone | 617-419-0858
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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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 | 2084A0401X
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Taxonomy Name | Addiction Medicine (Psychiatry & Neurology) Physician
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License Number |
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License Number State |
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