Provider Demographics
NPI:1740622620
Name:HARRIS, BARBARA JANE
Entity type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:JANE
Last Name:HARRIS
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:BARBARA
Other - Middle Name:JANE
Other - Last Name:HARRIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SLP
Mailing Address - Street 1:5605 KIOWA DR
Mailing Address - Street 2:
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91942-1308
Mailing Address - Country:US
Mailing Address - Phone:619-697-0600
Mailing Address - Fax:
Practice Address - Street 1:5605 KIOWA DR
Practice Address - Street 2:
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91942-1308
Practice Address - Country:US
Practice Address - Phone:619-697-0600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-22
Last Update Date:2015-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP15575235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist