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General NPI Number Information
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NPI Number | 1295235612
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Entity Type | Organization
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Legal Business Name | TASA HARRIS
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Dates
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Enumeration Date | 02/13/2018
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Last Update Date | 04/09/2018
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Provider Practice Location Address
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Address Line | 810 N W S YOUNG DR STE A
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City | KILLEEN
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State | TX
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Zip | 76543-4050
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Country | US
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Telephone | 301-792-6224
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Fax |
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Provider Business Mailing Address
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Address Line | 6106 MALACHI LN
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City | KILLEEN
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State | TX
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Zip | 76542-5893
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Country | US
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Telephone | 301-792-6224
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Fax |
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Authorized Official
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Title or Position | PROVIDER/OWNER
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Name | TASA HARRIS
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Credential | LCSW
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Telephone | 301-792-6224
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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