Provider Demographics
NPI:1417194515
Name:HARRIS, TOSHA BENARD
Entity Type:Individual
Prefix:MS
First Name:TOSHA
Middle Name:BENARD
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 1:522 ARLINGTON DR
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70001-5516
Mailing Address - Country:US
Mailing Address - Phone:504-390-2110
Mailing Address - Fax:
Practice Address - Street 1:522 ARLINGTON DR
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70001-5516
Practice Address - Country:US
Practice Address - Phone:504-390-2110
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-12
Last Update Date:2009-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier