Individual
TASHA HARRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6402 PENROD ST, DETROIT, MI 48228-4748
(313) 914-8742
Mailing address
6402 PENROD ST, DETROIT, MI 48228-4748
(313) 914-8742
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
—
—
Other
Enumeration date
01/22/2016
Last updated
01/22/2016
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