Provider Demographics
NPI:1881858561
Name:HARRIS, LATASHA (SA)
Entity Type:Individual
Prefix:MISS
First Name:LATASHA
Middle Name:
Last Name:HARRIS
Suffix:
Gender:F
Credentials:SA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5529 WHITBY RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21206-3819
Mailing Address - Country:US
Mailing Address - Phone:443-850-5701
Mailing Address - Fax:
Practice Address - Street 1:5529 WHITBY RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21206-3819
Practice Address - Country:US
Practice Address - Phone:443-850-5701
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-11
Last Update Date:2008-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant