MEDICARE: MS. BARBARA HARRIS M.ED., ED.S., LPC

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	101YP2500X	Professional Counselor	01866	GA

General Provider Information

NPI Number	:	1417908781
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. BARBARA HARRIS M.ED., ED.S., LPC

Provider Business Mailing Address
First Line	:	PO BOX 1532
Second Line	:
City	:	STATESBORO
State	:	GA
Zip	:	30459-1532
Country	:	US
Telephone Number	:	912-489-5480
Fax Number	:	912-764-4113

Provider Business Practice Location Address
First Line	:	315 MEADOWLARK CIR
Second Line	:
City	:	STATESBORO
State	:	GA
Zip	:	30461-6973
Country	:	US
Telephone Number	:	912-489-5480
Fax Number	:	912-764-4113

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

Provider Enumeration Date	:	05/12/2006
Last Update Date	:	07/08/2007

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