Provider Demographics
NPI:1629260559
Name:HARRIS, MESHA (MS)
Entity Type:Individual
Prefix:MS
First Name:MESHA
Middle Name:
Last Name:HARRIS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2017 LYNDHURST AVE
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28203-5313
Mailing Address - Country:US
Mailing Address - Phone:704-609-8255
Mailing Address - Fax:704-371-7385
Practice Address - Street 1:2017 LYNDHURST AVE
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28203-5313
Practice Address - Country:US
Practice Address - Phone:704-609-8255
Practice Address - Fax:704-371-7385
Is Sole Proprietor?:No
Enumeration Date:2007-08-14
Last Update Date:2007-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6935235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist