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Individual

EDIE HARRIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PCA/CHHA

Contact information

Practice address
358 WATERVLIET SHAKER RD UNIT A, WATERVLIET, NY 12189
(518) 833-0450
Mailing address
358 WATERVLIET SHAKER RD UNIT A, WATERVLIET, NY 12189-0309
(518) 461-3969

Taxonomy

Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
00248381
NY

Other

Enumeration date
09/10/2015
Last updated
09/01/2018
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