Provider Demographics
NPI:1417165044
Name:HARRIS, STACY N (BA)
Entity Type:Individual
Prefix:MS
First Name:STACY
Middle Name:N
Last Name:HARRIS
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3535 QUAKERBRIDGE RD STE 201
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08619-1200
Mailing Address - Country:US
Mailing Address - Phone:609-584-0790
Mailing Address - Fax:609-584-0692
Practice Address - Street 1:3535 QUAKERBRIDGE RD STE 201
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08619-1200
Practice Address - Country:US
Practice Address - Phone:609-584-0790
Practice Address - Fax:609-584-0692
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health