| Gina M Harris Phd Pa | |
|
1035 S State Road 7 Ste 315-19 Wellington FL 33414-6134 | |
| (561) 791-3239 | |
| Not Available |
| Full Name | Gina M Harris Phd Pa |
|---|---|
| Speciality | Clinical Neuropsychologist |
| Location | 1035 S State Road 7 Ste 315-19, Wellington, Florida |
| Authorized Official Name and Position | Gina M. Harris (PRESIDENT) |
| Authorized Official Contact | 3054394893 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gina M Harris Phd Pa 5355 Ouachita Dr Lake Worth FL 33467-5541 Ph: (561) 965-2623 | Gina M Harris Phd Pa 1035 S State Road 7 Ste 315-19 Wellington FL 33414-6134 Ph: (561) 791-3239 |
| NPI Number | 1790965291 |
|---|---|
| Provider Enumeration Date | 11/13/2007 |
| Last Update Date | 11/13/2007 |
| Medicare PECOS PAC ID | 5890885503 |
|---|---|
| Medicare Enrollment ID | O20071219000200 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790965291 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | (* (Not Available)) | Primary |
| 103TC2200X | Psychologist - Clinical Child & Adolescent | (* (Not Available)) | Secondary |
| Provider Name | Gina M Harris |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1821215666 PECOS PAC ID: 7113016130 Enrollment ID: I20071128000688 |
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