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NPI Code Detail

MEDICARE: CIERRA TANESHA HARRIS

MEDICARE: CIERRA TANESHA 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 : 1689279325
Entity Type Code : Individual
Provider Name (Legal Business Name) : CIERRA TANESHA HARRIS
Provider Business Mailing Address
First Line : 5900 WARM SPRINGS RD STE J
Second Line :
City : COLUMBUS
State : GA
Zip : 31909-4597
Country : US
Telephone Number : 850-607-6910
Fax Number : 850-607-6932
Provider Business Practice Location Address
First Line : 5900 WARM SPRINGS RD STE J
Second Line :
City : COLUMBUS
State : GA
Zip : 31909-4597
Country : US
Telephone Number : 850-607-6910
Fax Number : 850-607-6932
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/01/2020
Last Update Date : 12/01/2020

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Directions to “ CIERRA TANESHA HARRIS ” Practice Location

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