Provider Demographics
NPI:1689022204
Name:HARRIS, SARAH ELAINE
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:ELAINE
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 1:7998 NE 17TH AVE
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34479-1385
Mailing Address - Country:US
Mailing Address - Phone:352-362-8801
Mailing Address - Fax:
Practice Address - Street 1:2102 SW 20TH PL
Practice Address - Street 2:UNIT 302
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-0861
Practice Address - Country:US
Practice Address - Phone:352-332-8588
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-25
Last Update Date:2017-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician