Provider Demographics
NPI:1225183775
Name:HARRIS, ROSALYN YAVETTE (LMSW)
Entity Type:Individual
Prefix:
First Name:ROSALYN
Middle Name:YAVETTE
Last Name:HARRIS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:ROSALYN
Other - Middle Name:YAVETTE
Other - Last Name:SIMMONS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 835066
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75083-5066
Mailing Address - Country:US
Mailing Address - Phone:972-490-9055
Mailing Address - Fax:972-490-9058
Practice Address - Street 1:7667 ROUNDROCK RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75248-5335
Practice Address - Country:US
Practice Address - Phone:972-490-9055
Practice Address - Fax:972-490-9058
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker