Provider Demographics
NPI:1972802080
Name:HARRIOTT, ITZEL (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ITZEL
Middle Name:
Last Name:HARRIOTT
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41077 ADELLE DR
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:LA
Mailing Address - Zip Code:70403-7538
Mailing Address - Country:US
Mailing Address - Phone:985-277-1023
Mailing Address - Fax:
Practice Address - Street 1:41077 ADELLE DR
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70403-7538
Practice Address - Country:US
Practice Address - Phone:985-277-1023
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-15
Last Update Date:2011-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA164761835P0018X
FL409641835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist