Provider Demographics
NPI:1922257450
Name:HARRIS, JENNIFER G (AUD)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:G
Last Name:HARRIS
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2937 7TH AVE S
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35233-2929
Mailing Address - Country:US
Mailing Address - Phone:205-251-7169
Mailing Address - Fax:205-254-3013
Practice Address - Street 1:2937 7TH AVE S
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35233-2929
Practice Address - Country:US
Practice Address - Phone:205-251-7169
Practice Address - Fax:205-254-3013
Is Sole Proprietor?:No
Enumeration Date:2008-09-09
Last Update Date:2011-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL940A231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist