Provider Demographics
NPI:1275046906
Name:HARRIS, GENEVIEVE HOLL (AUD)
Entity Type:Individual
Prefix:DR
First Name:GENEVIEVE
Middle Name:HOLL
Last Name:HARRIS
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:165 POND RUN LN
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32218-8984
Mailing Address - Country:US
Mailing Address - Phone:205-532-1008
Mailing Address - Fax:
Practice Address - Street 1:165 POND RUN LN
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32218-8984
Practice Address - Country:US
Practice Address - Phone:205-532-1008
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-16
Last Update Date:2017-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY2147237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter