Provider Demographics
NPI:1801411020
Name:HARRIS, CIERRA (SLPA)
Entity Type:Individual
Prefix:
First Name:CIERRA
Middle Name:
Last Name:HARRIS
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8111 N 19TH AVE APT 2056
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85021-5169
Mailing Address - Country:US
Mailing Address - Phone:602-515-2135
Mailing Address - Fax:
Practice Address - Street 1:4015 W WETHERSFIELD RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85029-2985
Practice Address - Country:US
Practice Address - Phone:480-666-9888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-12
Last Update Date:2020-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLPA123962355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant