Provider Demographics
NPI:1417352741
Name:HARRIS, KATHRYN (HCP)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:HARRIS
Suffix:
Gender:F
Credentials:HCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:740 BYPASS RD STE 10
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:KY
Mailing Address - Zip Code:40391-1053
Mailing Address - Country:US
Mailing Address - Phone:859-745-9907
Mailing Address - Fax:513-433-0134
Practice Address - Street 1:740 BYPASS RD STE 10
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:KY
Practice Address - Zip Code:40391-1053
Practice Address - Country:US
Practice Address - Phone:859-745-9907
Practice Address - Fax:513-433-0134
Is Sole Proprietor?:No
Enumeration Date:2014-10-29
Last Update Date:2015-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1018237700000X
OH03172237700000X
KY12-17237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist