Provider Demographics
NPI:1629422902
Name:HARRIS, KARIN
Entity Type:Individual
Prefix:
First Name:KARIN
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 1:73 FAIRFIELD ST
Mailing Address - Street 2:
Mailing Address - City:MIDDLEVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13406-1822
Mailing Address - Country:US
Mailing Address - Phone:315-738-3941
Mailing Address - Fax:
Practice Address - Street 1:73 FAIRFIELD ST
Practice Address - Street 2:
Practice Address - City:MIDDLEVILLE
Practice Address - State:NY
Practice Address - Zip Code:13406-1822
Practice Address - Country:US
Practice Address - Phone:315-738-3941
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-22
Last Update Date:2016-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation Therapist