Provider Demographics
NPI:1225357932
Name:HARRIS, ROBIN LYNETTE
Entity Type:Individual
Prefix:MS
First Name:ROBIN
Middle Name:LYNETTE
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 1:634 RANDINITA DR
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28311-2550
Mailing Address - Country:US
Mailing Address - Phone:910-583-7845
Mailing Address - Fax:
Practice Address - Street 1:634 RANDINITA DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28311-2550
Practice Address - Country:US
Practice Address - Phone:910-583-7845
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-19
Last Update Date:2010-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst