Provider Demographics
NPI:1295208510
Name:HARRIS, AARIKA (RBT)
Entity Type:Individual
Prefix:
First Name:AARIKA
Middle Name:
Last Name:HARRIS
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2104 LEWIS TURNER BLVD
Mailing Address - Street 2:
Mailing Address - City:FORT WALTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32547-1316
Mailing Address - Country:US
Mailing Address - Phone:850-862-3728
Mailing Address - Fax:850-862-6270
Practice Address - Street 1:575 BROOKMEADE DR
Practice Address - Street 2:
Practice Address - City:CRESTVIEW
Practice Address - State:FL
Practice Address - Zip Code:32539-6029
Practice Address - Country:US
Practice Address - Phone:850-306-2531
Practice Address - Fax:850-862-6270
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-09
Last Update Date:2019-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-19-75542106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician