Provider Demographics
NPI:1467272708
Name:HARRIS, ROSALIND RENEE
Entity type:Individual
Prefix:
First Name:ROSALIND
Middle Name:RENEE
Last Name:HARRIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1118 E PINE ST
Mailing Address - Street 2:
Mailing Address - City:COMPTON
Mailing Address - State:CA
Mailing Address - Zip Code:90221-1172
Mailing Address - Country:US
Mailing Address - Phone:341-226-1216
Mailing Address - Fax:
Practice Address - Street 1:1118 E PINE ST
Practice Address - Street 2:
Practice Address - City:COMPTON
Practice Address - State:CA
Practice Address - Zip Code:90221-1172
Practice Address - Country:US
Practice Address - Phone:341-226-1216
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-11
Last Update Date:2024-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst