Provider Demographics
NPI:1427745470
Name:HARRIS, MAQUESHA TENISE (RBT,)
Entity type:Individual
Prefix:MS
First Name:MAQUESHA
Middle Name:TENISE
Last Name:HARRIS
Suffix:
Gender:F
Credentials:RBT,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6201 COLLEYVILLE BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:COLLEYVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76034-6236
Mailing Address - Country:US
Mailing Address - Phone:817-952-8917
Mailing Address - Fax:
Practice Address - Street 1:6201 COLLEYVILLE BLVD STE 100
Practice Address - Street 2:
Practice Address - City:COLLEYVILLE
Practice Address - State:TX
Practice Address - Zip Code:76034-6236
Practice Address - Country:US
Practice Address - Phone:817-952-8917
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-20
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician