Provider Demographics
NPI:1952012577
Name:HARRIS, KANIKA SHANI
Entity Type:Individual
Prefix:
First Name:KANIKA
Middle Name:SHANI
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 1:850 LEORA LN APT 513
Mailing Address - Street 2:
Mailing Address - City:THE COLONY
Mailing Address - State:TX
Mailing Address - Zip Code:75056-4599
Mailing Address - Country:US
Mailing Address - Phone:916-389-5122
Mailing Address - Fax:
Practice Address - Street 1:850 LEORA LN APT 513
Practice Address - Street 2:
Practice Address - City:THE COLONY
Practice Address - State:TX
Practice Address - Zip Code:75056-4599
Practice Address - Country:US
Practice Address - Phone:916-389-5122
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-06
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty