Individual
MYA HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
415 SECURITY SQ, GULFPORT, MS 39507-1922
(228) 229-8297
Mailing address
415 SECURITY SQ, GULFPORT, MS 39507-1922
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-15-11100
MS
Other
Enumeration date
08/29/2022
Last updated
08/29/2022
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