Provider Demographics
NPI:1316712821
Name:HARRIS, MIKI S
Entity type:Individual
Prefix:
First Name:MIKI
Middle Name:S
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 1:7809 CEDAR GLEN WAY
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:OH
Mailing Address - Zip Code:45042-9246
Mailing Address - Country:US
Mailing Address - Phone:937-687-7413
Mailing Address - Fax:
Practice Address - Street 1:7809 CEDAR GLEN WAY
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:OH
Practice Address - Zip Code:45042-9246
Practice Address - Country:US
Practice Address - Phone:937-687-7413
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-15
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered