Provider Demographics
NPI:1689962144
Name:HARRIS, DALE AINSLEY
Entity type:Individual
Prefix:
First Name:DALE
Middle Name:AINSLEY
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 1:134 COLONY CIR S
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28409-3128
Mailing Address - Country:US
Mailing Address - Phone:757-404-0628
Mailing Address - Fax:
Practice Address - Street 1:4114 SHIPYARD BLVD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-6155
Practice Address - Country:US
Practice Address - Phone:910-343-8988
Practice Address - Fax:910-343-4144
Is Sole Proprietor?:No
Enumeration Date:2011-07-19
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9680225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist