Provider Demographics
NPI:1548478308
Name:HARRIS, STEPHANIE LYNN (MA)
Entity type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:LYNN
Last Name:HARRIS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40452 DOUGLAS DR
Mailing Address - Street 2:APT 101
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48188-1392
Mailing Address - Country:US
Mailing Address - Phone:734-398-7088
Mailing Address - Fax:
Practice Address - Street 1:40452 DOUGLAS DR
Practice Address - Street 2:APT 101
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48188-1392
Practice Address - Country:US
Practice Address - Phone:734-398-7088
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist