Provider Demographics
NPI:1497482152
Name:HARRIS, CAMILA
Entity type:Individual
Prefix:
First Name:CAMILA
Middle Name:
Last Name:HARRIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 ENSIGN DR STE B
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:CT
Mailing Address - Zip Code:06001-3773
Mailing Address - Country:US
Mailing Address - Phone:860-404-2461
Mailing Address - Fax:860-404-2612
Practice Address - Street 1:31 ENSIGN DR STE B
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:CT
Practice Address - Zip Code:06001-3773
Practice Address - Country:US
Practice Address - Phone:860-404-2461
Practice Address - Fax:860-404-2612
Is Sole Proprietor?:No
Enumeration Date:2022-08-03
Last Update Date:2025-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT6743225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist