Individual
MRS. CONNIE LINNETTE HARRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1380 E SILVERADO RANCH BLVD, LAS VEGAS, NV 89183-5924
(702) 491-1265
(702) 453-8874
Mailing address
1264 MOON VISION ST, HENDERSON, NV 89052
(701) 491-1265
(702) 453-8874
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
252Y00000X
Early Intervention Provider Agency
—
—
3747P1801X
Personal Care Attendant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1811262488
—
NV
Enumeration date
04/09/2015
Last updated
03/28/2022
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