Provider Demographics
NPI:1104683267
Name:HARLESS, MEGHAN JANE
Entity type:Individual
Prefix:
First Name:MEGHAN
Middle Name:JANE
Last Name:HARLESS
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 1:1307 LARKWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MOUNT STERLING
Mailing Address - State:KY
Mailing Address - Zip Code:40353-8826
Mailing Address - Country:US
Mailing Address - Phone:606-225-1872
Mailing Address - Fax:
Practice Address - Street 1:1307 LARKWOOD DR
Practice Address - Street 2:
Practice Address - City:MOUNT STERLING
Practice Address - State:KY
Practice Address - Zip Code:40353-8826
Practice Address - Country:US
Practice Address - Phone:606-225-1872
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-04
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist