Provider Demographics
NPI:1114161072
Name:HARWELL, TRICIA LYNN
Entity Type:Individual
Prefix:MRS
First Name:TRICIA
Middle Name:LYNN
Last Name:HARWELL
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 1:902 E 17TH ST
Mailing Address - Street 2:
Mailing Address - City:CAMERON
Mailing Address - State:TX
Mailing Address - Zip Code:76520-2012
Mailing Address - Country:US
Mailing Address - Phone:254-697-8161
Mailing Address - Fax:
Practice Address - Street 1:2104 N KARNES AVE
Practice Address - Street 2:
Practice Address - City:CAMERON
Practice Address - State:TX
Practice Address - Zip Code:76520-1055
Practice Address - Country:US
Practice Address - Phone:254-697-4985
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-22
Last Update Date:2009-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX24619235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist