Provider Demographics
NPI:1801232699
Name:HARRIS, YVONNE LAWE (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:YVONNE
Middle Name:LAWE
Last Name:HARRIS
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:YVONNE
Other - Middle Name:ANN
Other - Last Name:LAWE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3913 TRAILS END CIR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:MD
Mailing Address - Zip Code:21131-1858
Mailing Address - Country:US
Mailing Address - Phone:512-731-5622
Mailing Address - Fax:
Practice Address - Street 1:1818 POT SPRING RD STE 100
Practice Address - Street 2:
Practice Address - City:LUTHERVILLE
Practice Address - State:MD
Practice Address - Zip Code:21093-4450
Practice Address - Country:US
Practice Address - Phone:410-583-5765
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-20
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD04051235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist