MEDICARE: RAYANNA C. 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
1	225700000X	Massage Therapist	MT-20960	AZ

General Provider Information

NPI Number	:	1518669910
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAYANNA C. HARRIS

Provider Business Mailing Address
First Line	:	40924 N LAMBERT TRL
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85086-3915
Country	:	US
Telephone Number	:	602-390-0818
Fax Number	:

Provider Business Practice Location Address
First Line	:	40924 N LAMBERT TRL
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85086-3915
Country	:	US
Telephone Number	:	602-390-0818
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/20/2023
Last Update Date	:	03/20/2023

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