Provider Demographics
NPI:1790916203
Name:HARRIS, LYNN MARIE (MA CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:LYNN
Middle Name:MARIE
Last Name:HARRIS
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:LYNN
Other - Middle Name:MARIE
Other - Last Name:DEVINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA CCC-SLP
Mailing Address - Street 1:250 CONTINENTAL DR
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OH
Mailing Address - Zip Code:44460-2508
Mailing Address - Country:US
Mailing Address - Phone:330-332-0317
Mailing Address - Fax:330-332-0318
Practice Address - Street 1:250 CONTINENTAL DR
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OH
Practice Address - Zip Code:44460-2508
Practice Address - Country:US
Practice Address - Phone:330-332-0317
Practice Address - Fax:330-332-0318
Is Sole Proprietor?:No
Enumeration Date:2009-07-31
Last Update Date:2009-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP. 9035235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist