Individual
MS. BRENDA FRANCES HARRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP-L
Contact information
Practice address
1807 222ND PL, SAUK VILLAGE, IL 60411-5047
(708) 757-9237
Mailing address
18656 DIXIE HWY, HOMEWOOD, IL 60430-3729
(708) 323-7057
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
146-005954
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
146-005954
IL STATE LICENSE, SPEECH PATHOLOGY
IL
Enumeration date
08/14/2012
Last updated
08/14/2012
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