Provider Demographics
NPI:1548047913
Name:HARRISON, ISABELLE MARIE (OT)
Entity type:Individual
Prefix:
First Name:ISABELLE
Middle Name:MARIE
Last Name:HARRISON
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:ISABELLE
Other - Middle Name:MARIE
Other - Last Name:PORTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:PO BOX 601791
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-1791
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:703 COMFORT LN
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NC
Practice Address - Zip Code:28112-5684
Practice Address - Country:US
Practice Address - Phone:704-323-2650
Practice Address - Fax:704-226-1158
Is Sole Proprietor?:No
Enumeration Date:2023-09-11
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC16033225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist