Individual
LISA HARADA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6701 FANNIN ST, HOUSTON, TX 77030-2608
(832) 828-3660
Mailing address
PO BOX 30180, SALT LAKE CITY, UT 84130-0180
(808) 561-9254
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
9460190-4405
UT
Other
Enumeration date
11/04/2013
Last updated
12/29/2015
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