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General NPI Number Information
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NPI Number | 1740539998
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Entity Type | Individual
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Provider Name | TASA HARRIS LCSW
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Gender | Female
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Dates
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Enumeration Date | 09/04/2012
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 810 N W S YOUNG DR STE 107A
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City | KILLEEN
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State | TX
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Zip | 76543-4052
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Country | US
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Telephone | 254-661-3381
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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 |
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LC50079456
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 63748
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License Number State | TX
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