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General NPI Number Information
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NPI Number | 1386054237
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Entity Type | Individual
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Provider Name | CECELIA HARRIS M.A., CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 04/30/2014
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Last Update Date | 04/30/2014
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Provider Practice Location Address
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Address Line | 11216 GERMANIA RD
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City | MABELVALE
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State | AR
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Zip | 72103-4009
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Country | US
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Telephone | 417-664-0355
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Fax |
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Provider Business Mailing Address
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Address Line | 11216 GERMANIA RD
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City | MABELVALE
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State | AR
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Zip | 72103-4009
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Country | US
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Telephone | 417-664-0355
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SP#3463
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 2013024910
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License Number State | MO
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