Provider Demographics
NPI:1528245594
Name:HARRIS, REGINA FAYE (LMSW-IPR)
Entity type:Individual
Prefix:MS
First Name:REGINA
Middle Name:FAYE
Last Name:HARRIS
Suffix:
Gender:F
Credentials:LMSW-IPR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2802 MANSFIELD ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77091-4716
Mailing Address - Country:US
Mailing Address - Phone:832-967-3870
Mailing Address - Fax:713-686-6471
Practice Address - Street 1:2802 MANSFIELD ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77091-4716
Practice Address - Country:US
Practice Address - Phone:832-967-3870
Practice Address - Fax:713-686-6471
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-22
Last Update Date:2008-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX32137171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator