Individual
MELVINA HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
700 PIERRE AVE STE A, SHREVEPORT, LA 71103-2725
(318) 532-9214
Mailing address
7313 UNIVERSITY DR, SHREVEPORT, LA 71105-5027
(318) 532-9214
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
815316856
—
LA
Enumeration date
06/26/2017
Last updated
06/26/2017
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