MEDICARE: MRS. ELIZABETH HARRIS OTR/L

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
1	225XP0200X	Pediatric Occupational Therapist	105010	MN
2	225X00000X	Occupational Therapist	105010	MN

General Provider Information

NPI Number	:	1235502469
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ELIZABETH HARRIS OTR/L

Provider Business Mailing Address
First Line	:	5637 BROOKLYN BLVD
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55429-3061
Country	:	US
Telephone Number	:	763-432-3926
Fax Number	:

Provider Business Practice Location Address
First Line	:	5637 BROOKLYN BLVD
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55429-3061
Country	:	US
Telephone Number	:	763-432-3926
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/10/2015
Last Update Date	:	07/15/2025

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