Individual
CORLISS HARRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
142 OAK DR SW, ATLANTA, GA 30354-2650
(404) 895-2242
Mailing address
142 OAK DR SW, ATLANTA, GA 30354-2650
(404) 895-2242
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000
DEPARTMENT OF VA
—
Enumeration date
02/05/2020
Last updated
02/05/2020
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