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NPI Code Detail

MEDICARE: SIERRA HARRIS

MEDICARE: SIERRA 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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1497409213
Entity Type Code : Individual
Provider Name (Legal Business Name) : SIERRA HARRIS
Provider Business Mailing Address
First Line : 4075 PARK AVE
Second Line :
City : MEMPHIS
State : TN
Zip : 38111-7400
Country : US
Telephone Number : 901-633-6790
Fax Number :
Provider Business Practice Location Address
First Line : 4075 PARK AVE
Second Line :
City : MEMPHIS
State : TN
Zip : 38111-7400
Country : US
Telephone Number : 901-584-8281
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/10/2022
Last Update Date : 02/10/2022

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Directions to “ SIERRA HARRIS ” Practice Location

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