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General NPI Number Information
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NPI Number | 1912029513
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Entity Type | Individual
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Provider Name | MICHELE L HARRIS PTA
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Gender | Female
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Dates
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Enumeration Date | 04/04/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 22317 DUPONT BLVD
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City | GEORGETOWN
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State | DE
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Zip | 19947-2153
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Country | US
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Telephone | 302-856-7364
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Fax |
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Provider Business Mailing Address
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Address Line | 29961 ADKINS LN
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City | DAGSBORO
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State | DE
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Zip | 19939-3984
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Country | US
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Telephone | 302-732-6089
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | J2-0000582
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License Number State | DE
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