Provider Demographics
NPI:1538693551
Name:HARRIS, MARILYN
Entity Type:Individual
Prefix:MISS
First Name:MARILYN
Middle Name:
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 1:2724 PHYLLIS CIR N
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-5618
Mailing Address - Country:US
Mailing Address - Phone:406-794-4875
Mailing Address - Fax:
Practice Address - Street 1:2724 PHYLLIS CIR N
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-5618
Practice Address - Country:US
Practice Address - Phone:406-794-4875
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-17
Last Update Date:2017-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist