Provider Demographics
NPI:1023362761
Name:HARRIS, ALBERTA LASHAE (DPT)
Entity type:Individual
Prefix:MRS
First Name:ALBERTA
Middle Name:LASHAE
Last Name:HARRIS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:MS
Other - First Name:ALBERTA
Other - Middle Name:LASHAE
Other - Last Name:PRESBERRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:13201 MAGISTERIAL DR
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40223-4105
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:13201 MAGISTERIAL DR
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40223-4105
Practice Address - Country:US
Practice Address - Phone:800-645-5678
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-02
Last Update Date:2012-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY006137225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist