Individual
MRS. TORYA LACHE' HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
2050 WATSON BLVD STE A, WARNER ROBINS, GA 31093-3625
(478) 352-1264
Mailing address
4501 RUSSELL PKWY STE 37, WARNER ROBINS, GA 31088-8681
(478) 352-1264
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
OTA001309
GA
225700000X
Massage Therapist
Primary
MT004335
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
81-3152487
—
GA
Enumeration date
07/06/2016
Last updated
05/10/2021
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