Provider Demographics
NPI:1972081206
Name:HARRIS, ALESHA NICOLE (OTR/L)
Entity Type:Individual
Prefix:
First Name:ALESHA
Middle Name:NICOLE
Last Name:HARRIS
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1740 MILLER PIKE
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:KY
Mailing Address - Zip Code:40033-9257
Mailing Address - Country:US
Mailing Address - Phone:270-940-0295
Mailing Address - Fax:
Practice Address - Street 1:636 GOLFVIEW TER
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:KY
Practice Address - Zip Code:40033-1947
Practice Address - Country:US
Practice Address - Phone:270-940-0295
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-30
Last Update Date:2022-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist