Doctor Name: | MICHELLE HARRISON |
NPI Number: | 1619027281 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.A. |
License Number: | SA9496 |
Business Practice Address: | 23 30th Ave S Jacksonville Beach, FL - 322505932 |
Business Phone Number: | 2178413911 |
Business Fax Number: | |
Mailing Address: | 23 30th Ave S, JACKSONVILLE BEACH |
State: | FL |
Postal Code: | 322505932 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 01/12/2007 |
NPI Last Update Date: | 06/09/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SA9496 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | FL |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |