Individual
MISS TANISHA RENEE HARRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, OTR/L
Contact information
Practice address
806 LOUISIANA ST, RICHMOND, VA 23231-1212
(804) 539-8567
Mailing address
806 LOUISIANA ST, RICHMOND, VA 23231-1212
(804) 539-8567
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
0119004302
VA
225X00000X
Occupational Therapist
Primary
OT004611
GA
Other
Enumeration date
09/12/2007
Last updated
09/15/2007
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