Provider Demographics
NPI:1326335738
Name:HARRIS, CAROLYN DENICE (MA CCC/SLP)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:DENICE
Last Name:HARRIS
Suffix:
Gender:F
Credentials:MA CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7214 FM 1488 RD
Mailing Address - Street 2:SUITE 108
Mailing Address - City:MAGNOLIA
Mailing Address - State:TX
Mailing Address - Zip Code:77354-2762
Mailing Address - Country:US
Mailing Address - Phone:281-259-5552
Mailing Address - Fax:281-259-5593
Practice Address - Street 1:7214 FM 1488 RD
Practice Address - Street 2:SUITE 108
Practice Address - City:MAGNOLIA
Practice Address - State:TX
Practice Address - Zip Code:77354-2762
Practice Address - Country:US
Practice Address - Phone:281-259-5552
Practice Address - Fax:281-259-5593
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-06
Last Update Date:2011-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12746235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist