Individual
EBONI B HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7601 PARKLANE RD, COLUMBIA, SC 29223-6122
(803) 741-9090
Mailing address
2381 TALL OAK RD, SUMTER, SC 29154-1121
(803) 565-7095
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5154
SC
Other
Enumeration date
10/15/2020
Last updated
10/15/2020
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