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NPI Code Detail

MEDICARE: HAILEY BREANNA HARRIS

MEDICARE: HAILEY BREANNA HARRIS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) CounselorCDCA.193221OH
2175T00000XPeer SpecialistAPS.004426OH

General Provider Information

NPI Number : 1225815723
Entity Type Code : Individual
Provider Name (Legal Business Name) : HAILEY BREANNA HARRIS
Provider Business Mailing Address
First Line : 131 WERTZ AVE NW
Second Line :
City : CANTON
State : OH
Zip : 44708-4171
Country : US
Telephone Number : 234-214-8470
Fax Number :
Provider Business Practice Location Address
First Line : 131 WERTZ AVE NW
Second Line :
City : CANTON
State : OH
Zip : 44708-4171
Country : US
Telephone Number : 234-214-8470
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/11/2023
Last Update Date : 01/20/2026

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Directions to “ HAILEY BREANNA HARRIS ” Practice Location

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