Provider Demographics
NPI:1942182787
Name:HARRIS, JACOBI SHANICE (BCBA)
Entity type:Individual
Prefix:
First Name:JACOBI
Middle Name:SHANICE
Last Name:HARRIS
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3500 S GREAT SOUTHWEST PKWY APT 113
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75052-7383
Mailing Address - Country:US
Mailing Address - Phone:469-836-8167
Mailing Address - Fax:
Practice Address - Street 1:3142 S HIGHWAY 161 STE 430
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75052-7792
Practice Address - Country:US
Practice Address - Phone:469-808-1101
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-23
Last Update Date:2025-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst