Provider Demographics
NPI:1427346915
Name:HARRIS, JACQUELINE
Entity type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:
Last Name:HARRIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JACQUELINE
Other - Middle Name:
Other - Last Name:HARRIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:10190 KATY FWY STE 351
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77043-5239
Mailing Address - Country:US
Mailing Address - Phone:832-675-2275
Mailing Address - Fax:
Practice Address - Street 1:10190 KATY FWY
Practice Address - Street 2:STE 351
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77043-5239
Practice Address - Country:US
Practice Address - Phone:832-675-2275
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-18
Last Update Date:2011-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health