Provider Demographics
NPI:1700162807
Name:HARRIS, ANN BARBARA (MS, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:ANN
Middle Name:BARBARA
Last Name:HARRIS
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:MS
Other - First Name:BARBARA
Other - Middle Name:ANN
Other - Last Name:PARKIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:411 PRAIRIE RIDGE LN
Mailing Address - Street 2:
Mailing Address - City:NORTH AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60542-1293
Mailing Address - Country:US
Mailing Address - Phone:708-707-3766
Mailing Address - Fax:
Practice Address - Street 1:411 PRAIRIE RIDGE LN
Practice Address - Street 2:
Practice Address - City:NORTH AURORA
Practice Address - State:IL
Practice Address - Zip Code:60542-1293
Practice Address - Country:US
Practice Address - Phone:708-707-3766
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-02
Last Update Date:2014-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146007417235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist