Provider Demographics
NPI:1831449693
Name:HARRIS, TRENT ALAN (HIS, HAD)
Entity type:Individual
Prefix:MR
First Name:TRENT
Middle Name:ALAN
Last Name:HARRIS
Suffix:
Gender:M
Credentials:HIS, HAD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3907 CALUMET AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:VALPARAISO
Mailing Address - State:IN
Mailing Address - Zip Code:46383-2286
Mailing Address - Country:US
Mailing Address - Phone:219-462-6866
Mailing Address - Fax:219-462-9369
Practice Address - Street 1:3907 CALUMET AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:VALPARAISO
Practice Address - State:IN
Practice Address - Zip Code:46383-2269
Practice Address - Country:US
Practice Address - Phone:219-462-6866
Practice Address - Fax:219-462-9369
Is Sole Proprietor?:No
Enumeration Date:2012-09-19
Last Update Date:2024-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN17001437A237700000X, 237700000X
IN237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter