MEDICARE: NORMA NORMA HARRIS MA, PH,D, MA

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	0442557	CO

General Provider Information

NPI Number	:	1609008325
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NORMA NORMA HARRIS MA, PH,D, MA

Provider Business Mailing Address
First Line	:	615 E 10TH AVE APT 9
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80203-3252
Country	:	US
Telephone Number	:	729-891-3993
Fax Number	:

Provider Business Practice Location Address
First Line	:	615 E 10TH AVE APT 9
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80203-3252
Country	:	US
Telephone Number	:	729-891-3993
Fax Number	:

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

Provider Enumeration Date	:	08/13/2009
Last Update Date	:	08/13/2009

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