Provider Demographics
NPI:1821393992
Name:HARRISON, NARA C (MS/SLP)
Entity Type:Individual
Prefix:
First Name:NARA
Middle Name:C
Last Name:HARRISON
Suffix:
Gender:F
Credentials:MS/SLP
Other - Prefix:
Other - First Name:NARA
Other - Middle Name:C
Other - Last Name:BROOKES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS/SLP
Mailing Address - Street 1:1421 3RD ST SW
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24016-5204
Mailing Address - Country:US
Mailing Address - Phone:540-982-2208
Mailing Address - Fax:540-982-7637
Practice Address - Street 1:1421 3RD ST SW
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24016-5204
Practice Address - Country:US
Practice Address - Phone:540-982-2208
Practice Address - Fax:540-982-7637
Is Sole Proprietor?:No
Enumeration Date:2011-01-20
Last Update Date:2016-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202006154235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist