Individual
MADELYN HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3-3367 KUHIO HWY, SUITE 211, LIHUE, HI 96766-1034
(800) 991-6070
(800) 991-6071
Mailing address
140 W FRANKLIN ST STE 202, MONTEREY, CA 93940-2725
(800) 991-6070
(800) 991-6071
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000362673
HMSA
—
Enumeration date
10/28/2016
Last updated
10/28/2016
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