Provider Demographics
NPI:1972195006
Name:HARRIS, NAEEMAH ELIDA
Entity Type:Individual
Prefix:
First Name:NAEEMAH
Middle Name:ELIDA
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 1:240 TALMADGE ST
Mailing Address - Street 2:
Mailing Address - City:NEW BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08901-3037
Mailing Address - Country:US
Mailing Address - Phone:908-247-4884
Mailing Address - Fax:
Practice Address - Street 1:240 TALMADGE ST
Practice Address - Street 2:
Practice Address - City:NEW BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08901-3037
Practice Address - Country:US
Practice Address - Phone:908-247-4884
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-10
Last Update Date:2021-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool