Provider Demographics
NPI:1003500760
Name:HARRIS, KAMILAH (CLC)
Entity Type:Individual
Prefix:
First Name:KAMILAH
Middle Name:
Last Name:HARRIS
Suffix:
Gender:F
Credentials:CLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3741 NW 84TH AVE APT 1A
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33351-6170
Mailing Address - Country:US
Mailing Address - Phone:754-300-6755
Mailing Address - Fax:
Practice Address - Street 1:3741 NW 84TH AVE APT 1A
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33351-6170
Practice Address - Country:US
Practice Address - Phone:754-300-6755
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-06
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
No174N00000XOther Service ProvidersLactation Consultant, Non-RN
No175T00000XOther Service ProvidersPeer Specialist
No171400000XOther Service ProvidersHealth & Wellness Coach
No172V00000XOther Service ProvidersCommunity Health Worker