Provider Demographics
NPI:1427544964
Name:HARRIS, AMY DEANNE
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:DEANNE
Last Name:HARRIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48 CHESSER CRANE RD STE I
Mailing Address - Street 2:
Mailing Address - City:CHELSEA
Mailing Address - State:AL
Mailing Address - Zip Code:35043-8339
Mailing Address - Country:US
Mailing Address - Phone:205-618-8095
Mailing Address - Fax:
Practice Address - Street 1:48 CHESSER CRANE RD STE I
Practice Address - Street 2:
Practice Address - City:CHELSEA
Practice Address - State:AL
Practice Address - Zip Code:35043-8339
Practice Address - Country:US
Practice Address - Phone:205-618-8095
Practice Address - Fax:205-936-4157
Is Sole Proprietor?:No
Enumeration Date:2018-07-09
Last Update Date:2018-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3838235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist