Provider Demographics
NPI:1417521030
Name:HARRIS, ALYSHA (CHP)
Entity Type:Individual
Prefix:
First Name:ALYSHA
Middle Name:
Last Name:HARRIS
Suffix:
Gender:F
Credentials:CHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8160 N THOMAS MEYERS DR APT G
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64118-9512
Mailing Address - Country:US
Mailing Address - Phone:816-602-6743
Mailing Address - Fax:
Practice Address - Street 1:190 NE 91ST ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64155-3329
Practice Address - Country:US
Practice Address - Phone:816-602-6743
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-18
Last Update Date:2021-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist