Provider Demographics
NPI:1598411258
Name:HARRIS, LATOSHA D (CSFA)
Entity type:Individual
Prefix:
First Name:LATOSHA
Middle Name:D
Last Name:HARRIS
Suffix:
Gender:F
Credentials:CSFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 600324
Mailing Address - Street 2:
Mailing Address - City:ST THOMAS
Mailing Address - State:VI
Mailing Address - Zip Code:00801-6324
Mailing Address - Country:US
Mailing Address - Phone:470-216-4683
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 600324
Practice Address - Street 2:
Practice Address - City:ST THOMAS
Practice Address - State:VI
Practice Address - Zip Code:00801-6324
Practice Address - Country:US
Practice Address - Phone:470-216-4683
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-22
Last Update Date:2025-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant