Provider Demographics
NPI:1710434857
Name:HARRIS, ROBIN MARIE
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:MARIE
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 1:2039 AMBER WAY
Mailing Address - Street 2:
Mailing Address - City:WINDSOR MILL
Mailing Address - State:MD
Mailing Address - Zip Code:21244-1240
Mailing Address - Country:US
Mailing Address - Phone:443-219-7004
Mailing Address - Fax:
Practice Address - Street 1:2039 AMBER WAY
Practice Address - Street 2:
Practice Address - City:WINDSOR MILL
Practice Address - State:MD
Practice Address - Zip Code:21244-1240
Practice Address - Country:US
Practice Address - Phone:443-219-7004
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-07
Last Update Date:2016-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health