Provider Demographics
NPI:1154069748
Name:HARRIS, DANNIQUA CHAMBREE
Entity Type:Individual
Prefix:MISS
First Name:DANNIQUA
Middle Name:CHAMBREE
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 1:1050 COUNTRY CLUB DR
Mailing Address - Street 2:
Mailing Address - City:UNION POINT
Mailing Address - State:GA
Mailing Address - Zip Code:30669-1424
Mailing Address - Country:US
Mailing Address - Phone:706-817-9301
Mailing Address - Fax:
Practice Address - Street 1:1050 COUNTRY CLUB DR
Practice Address - Street 2:
Practice Address - City:UNION POINT
Practice Address - State:GA
Practice Address - Zip Code:30669-1424
Practice Address - Country:US
Practice Address - Phone:706-817-9301
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-24
Last Update Date:2022-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare