Provider Demographics
NPI:1689080624
Name:HARRIS, JILL (MS)
Entity Type:Individual
Prefix:
First Name:JILL
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 1:6811 AUSTIN CENTER BLVD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-3146
Mailing Address - Country:US
Mailing Address - Phone:512-628-1840
Mailing Address - Fax:512-628-1841
Practice Address - Street 1:6811 AUSTIN CENTER BLVD
Practice Address - Street 2:SUITE 400
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-3146
Practice Address - Country:US
Practice Address - Phone:512-628-1840
Practice Address - Fax:512-628-1841
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-10
Last Update Date:2015-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS