Individual
MRS. TINA HARRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
300 SEVILLE RD, HURRICANE, WV 25526-9206
(304) 757-6805
Mailing address
301A PIKE ST, COAL GROVE, OH 45638-3135
(740) 357-5338
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
C1143
WV
Other
Enumeration date
05/28/2007
Last updated
07/08/2007
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