Individual
KHADIJAH D HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1316 N TREMAIN ST, MOUNT DORA, FL 32757-3840
(352) 800-8118
Mailing address
1316 N TREMAIN ST, MOUNT DORA, FL 32757-3840
(352) 800-8118
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
CNA354739
FL
Other
Enumeration date
10/12/2021
Last updated
10/12/2021
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