Provider Demographics
NPI:1093174229
Name:HARRIS, VALNECIA TREACTRICE
Entity Type:Individual
Prefix:MRS
First Name:VALNECIA
Middle Name:TREACTRICE
Last Name:HARRIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2750 S DURANGO DR
Mailing Address - Street 2:2078
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-2636
Mailing Address - Country:US
Mailing Address - Phone:702-574-6453
Mailing Address - Fax:
Practice Address - Street 1:2750 S DURANGO DR
Practice Address - Street 2:2078
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-2636
Practice Address - Country:US
Practice Address - Phone:702-574-6453
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-16
Last Update Date:2016-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities