Provider Demographics
NPI:1639410517
Name:HARRIS, ALICIA
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:
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 1:1601 E LAMAR BLVD
Mailing Address - Street 2:STE 218
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76011-4510
Mailing Address - Country:US
Mailing Address - Phone:469-443-6970
Mailing Address - Fax:
Practice Address - Street 1:1601 E LAMAR BLVD
Practice Address - Street 2:STE 218
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76011-4510
Practice Address - Country:US
Practice Address - Phone:469-443-6970
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-03
Last Update Date:2013-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
No374U00000XNursing Service Related ProvidersHome Health Aide