Organization
GINA M HARRIS PHD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GINA M. HARRIS PH.D. (PRESIDENT)
(305) 439-4893
Entity
Organization
Contact information
Practice address
1035 S STATE ROAD 7 STE 315-19, WELLINGTON, FL 33414-6134
(561) 791-3239
Mailing address
5355 OUACHITA DR, LAKE WORTH, FL 33467-5541
(561) 965-2623
(561) 963-3606
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
Other
Enumeration date
11/13/2007
Last updated
11/13/2007
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