Provider Demographics
NPI:1396924775
Name:STEPHANIE J. HARRIS, PA
Entity type:Organization
Organization Name:STEPHANIE J. HARRIS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:JOY
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:561-955-9800
Mailing Address - Street 1:7300 W CAMINO REAL
Mailing Address - Street 2:SUITE 202
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-5512
Mailing Address - Country:US
Mailing Address - Phone:561-955-9800
Mailing Address - Fax:561-955-9800
Practice Address - Street 1:7300 W CAMINO REAL
Practice Address - Street 2:SUITE 202
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-5512
Practice Address - Country:US
Practice Address - Phone:561-955-9800
Practice Address - Fax:561-955-9800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-01
Last Update Date:2007-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY6881103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty