Most Relevant Information
Provider Data
| NPI Number: | 1003018045 |
| Provider Name: | ALICIA HARRIS ST |
| Entity Type: | Individual |
| Taxonomy Code: | 235Z00000X |
| Specialty: | Speech-Language Pathologist |
| License Number: | SA 8637 |
Most Important Dates
| Enumeration Date: | 06/01/2007 |
| Last Updated: | 07/08/2007 |
Provider Practice Location
1335 ARIANA ST
LAKELAND
FL
338031879
Practice Location Phone/Fax
| Phone: | 8634130802 |
| Fax: | 8638130812 |
Provider Mailing Location
1335 ARIANA ST
LAKELAND
FL
338031879
Provider Mailing Phone/Fax
| Phone: | 8634130802 |
| Fax: | 8638130812 |