Provider Demographics
NPI:1023824349
Name:HARRIS, TONISHA (DSP)
Entity type:Individual
Prefix:
First Name:TONISHA
Middle Name:
Last Name:HARRIS
Suffix:
Gender:F
Credentials:DSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4616 BUCKSKIN TRL
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45245-1247
Mailing Address - Country:US
Mailing Address - Phone:419-612-3866
Mailing Address - Fax:
Practice Address - Street 1:1728 ADAMS RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45231-3135
Practice Address - Country:US
Practice Address - Phone:419-612-3866
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-10
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty
No376J00000XNursing Service Related ProvidersHomemaker