MEDICARE: MS. REGINA FAYE HARRIS LMSW-IPR

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	171M00000X	Case Manager/Care Coordinator	32137	TX

General Provider Information

NPI Number	:	1528245594
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. REGINA FAYE HARRIS LMSW-IPR

Provider Business Mailing Address
First Line	:	2802 MANSFIELD ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77091-4716
Country	:	US
Telephone Number	:	832-967-3870
Fax Number	:	713-686-6471

Provider Business Practice Location Address
First Line	:	2802 MANSFIELD ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77091-4716
Country	:	US
Telephone Number	:	832-967-3870
Fax Number	:	713-686-6471

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

Provider Enumeration Date	:	01/22/2008
Last Update Date	:	01/22/2008

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