Individual
TA'NIQUA JESSICA HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MOTR/L
Contact information
Practice address
7 CORPORATE CENTER CT STE B, GREENSBORO, NC 27408-3839
(336) 967-1649
(336) 276-1728
Mailing address
7 CORPORATE CENTER CT STE B, GREENSBORO, NC 27408-3839
(336) 967-1649
(336) 276-1728
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
11785
NC
225X00000X
Occupational Therapist
18169
FL
225X00000X
Occupational Therapist
Primary
377218
NC
225X00000X
Occupational Therapist
5819
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1548836406
—
NC
01
—
20JDA
BCBS NC
NC
Enumeration date
01/02/2017
Last updated
05/11/2026
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