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NPI Code Detail

MEDICARE: MRS. ALESHIA ARIEL HARRIS OTR/L

MEDICARE: MRS. ALESHIA ARIEL HARRIS OTR/L
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
1225X00000XOccupational Therapist170941KY

General Provider Information

NPI Number : 1487106480
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ALESHIA ARIEL HARRIS OTR/L
Provider Business Mailing Address
First Line : 1043 BROOKLYN BLVD
Second Line : P.O. BOX 1048
City : BEREA
State : KY
Zip : 40403-1090
Country : US
Telephone Number : 859-228-0551
Fax Number :
Provider Business Practice Location Address
First Line : 1043 BROOKLYN BLVD
Second Line :
City : BEREA
State : KY
Zip : 40403-1090
Country : US
Telephone Number : 859-228-0551
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/26/2016
Last Update Date : 10/26/2016

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