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NPI Code Detail

MEDICARE: MRS. MARY SUSAN HARRIS L.P.C.

MEDICARE: MRS. MARY SUSAN HARRIS L.P.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional CounselorPC003086PA

General Provider Information

NPI Number : 1194821306
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MARY SUSAN HARRIS L.P.C.
Provider Business Mailing Address
First Line : 4808 WARRIORS MARK PATH
Second Line :
City : TYRONE
State : PA
Zip : 16686-3626
Country : US
Telephone Number : 814-632-6124
Fax Number :
Provider Business Practice Location Address
First Line : 304 FRANKSTOWN RD
Second Line :
City : ALTOONA
State : PA
Zip : 16602-4231
Country : US
Telephone Number : 814-414-6477
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/15/2006
Last Update Date : 10/09/2008

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