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NPI Code Detail

MEDICARE: MRS. TORYA LACHE' HARRIS LMT

MEDICARE: MRS. TORYA LACHE' HARRIS LMT
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
1224Z00000XOccupational Therapy AssistantOTA001309GA
2225700000XMassage TherapistMT004335GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1912359670
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. TORYA LACHE' HARRIS LMT
Provider Business Mailing Address
First Line : 4501 RUSSELL PKWY STE 37
Second Line :
City : WARNER ROBINS
State : GA
Zip : 31088-8681
Country : US
Telephone Number : 478-352-1264
Fax Number :
Provider Business Practice Location Address
First Line : 2050 WATSON BLVD STE A
Second Line :
City : WARNER ROBINS
State : GA
Zip : 31093-3625
Country : US
Telephone Number : 478-352-1264
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/06/2016
Last Update Date : 05/10/2021

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