Provider Demographics
NPI:1790420156
Name:HARRIS, IESHA
Entity Type:Individual
Prefix:MISS
First Name:IESHA
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:UNIVERSITY OF MEMPHIS COLLEGE OF EDUCATION
Mailing Address - Street 2:PATTERSON HALL ROOM 113
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38152
Mailing Address - Country:US
Mailing Address - Phone:901-678-2841
Mailing Address - Fax:901-678-5114
Practice Address - Street 1:UNIVERSITY OF MEMPHIS COLLEGE OF EDUCATION
Practice Address - Street 2:PATTERSON HALL ROOM 113
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38152
Practice Address - Country:US
Practice Address - Phone:901-678-2841
Practice Address - Fax:901-678-5114
Is Sole Proprietor?:No
Enumeration Date:2022-04-30
Last Update Date:2022-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program