Provider Demographics
NPI:1346597713
Name:HARMON, THERESE KATHRYN (MA, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:THERESE
Middle Name:KATHRYN
Last Name:HARMON
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:MRS
Other - First Name:THERESE
Other - Middle Name:SHANAHAN
Other - Last Name:HARMON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA, CCC-SLP
Mailing Address - Street 1:8 W HIAWATHA TRL
Mailing Address - Street 2:
Mailing Address - City:MOUNT PROSPECT
Mailing Address - State:IL
Mailing Address - Zip Code:60056-3856
Mailing Address - Country:US
Mailing Address - Phone:847-870-9980
Mailing Address - Fax:
Practice Address - Street 1:100 N RIVER RD
Practice Address - Street 2:
Practice Address - City:DES PLAINES
Practice Address - State:IL
Practice Address - Zip Code:60016-1209
Practice Address - Country:US
Practice Address - Phone:847-297-1800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-05
Last Update Date:2012-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.003842235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist