Provider Demographics
NPI:1063046381
Name:HARRIS, SHARON H
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:H
Last Name:HARRIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4420 FAIRWAY DR
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71109-4002
Mailing Address - Country:US
Mailing Address - Phone:318-550-7818
Mailing Address - Fax:
Practice Address - Street 1:4420 FAIRWAY DR
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71109-4002
Practice Address - Country:US
Practice Address - Phone:318-550-7818
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-25
Last Update Date:2020-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor