Provider Demographics
NPI:1265116479
Name:HARRIS, AARON (SLP)
Entity type:Individual
Prefix:
First Name:AARON
Middle Name:
Last Name:HARRIS
Suffix:
Gender:M
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1475
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50305-1475
Mailing Address - Country:US
Mailing Address - Phone:515-643-7050
Mailing Address - Fax:515-643-7051
Practice Address - Street 1:25 W HICKMAN RD STE 200
Practice Address - Street 2:
Practice Address - City:WAUKEE
Practice Address - State:IA
Practice Address - Zip Code:50263-5021
Practice Address - Country:US
Practice Address - Phone:515-643-7050
Practice Address - Fax:515-643-7051
Is Sole Proprietor?:No
Enumeration Date:2023-06-09
Last Update Date:2024-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA126541235Z00000X
AZTSLP14473235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist