MEDICARE: DR. MARSHA R HARRIS PH.D., CCC/SLP

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	235Z00000X	Speech-Language Pathologist	11221	NC
2	235Z00000X	Speech-Language Pathologist	5890	SC

General Provider Information

NPI Number	:	1275706905
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARSHA R HARRIS PH.D., CCC/SLP

Provider Business Mailing Address
First Line	:	4926 STAR HILL LN
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28214-2506
Country	:	US
Telephone Number	:	301-938-1792
Fax Number	:

Provider Business Practice Location Address
First Line	:	4926 STAR HILL LN
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28214-2506
Country	:	US
Telephone Number	:	301-938-1792
Fax Number	:

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

Provider Enumeration Date	:	04/02/2008
Last Update Date	:	03/13/2017

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Directions to “ DR. MARSHA R HARRIS PH.D., CCC/SLP” Practice Location

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