Provider Demographics
NPI:1669707659
Name:HARR, ADRIENNE MARIE (MEDCCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:ADRIENNE
Middle Name:MARIE
Last Name:HARR
Suffix:
Gender:F
Credentials:MEDCCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2403 MARYLANE DR
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72756-6702
Mailing Address - Country:US
Mailing Address - Phone:479-790-7979
Mailing Address - Fax:479-631-8993
Practice Address - Street 1:2403 MARYLANE DR
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72756-6702
Practice Address - Country:US
Practice Address - Phone:479-790-7979
Practice Address - Fax:479-631-8993
Is Sole Proprietor?:No
Enumeration Date:2009-10-08
Last Update Date:2009-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARSP#2679235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist