Individual
JACQUELINE RAE HARRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
12441 HIGHWAY 26, RIVERTON, WY 82501-9256
(307) 857-4294
Mailing address
12441 HIGHWAY 26, RIVERTON, WY 82501-9256
(307) 857-4294
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
051
WY
Other
Enumeration date
05/09/2009
Last updated
05/09/2009
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