Brandy Mack Harris, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SLP008894 Issued in GA

Practice address

4505 Brandon Dr SW
Lilburn, GA 30047-4756

Phone

(404) 314-9375

NPI assigned

Jul 8, 2019

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1562544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562544000000",
    "number": "1265094536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4505 BRANDON DR SW",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "300474756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4505 BRANDON DR SW",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "300474756",
            "telephone_number": "404-314-9375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "BRANDY",
        "middle_name": "MACK",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-08",
        "last_updated": "2019-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP008894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Terrie Lynn Hampton, CHEF
• Maxine Handsor, D.A.
• Modesta S Hanley, FNP
• Ashley Nicole Hanna
• Lisa Hardy
• Tamara Marie Harris, PA-C
• Justin Harrison
• Harvey J. Schecter, D.O., P.C. Dba Total Care
• Theresa Lynn Harvey-Gilliard, RN
• Aeryka Miche'Le Harvey, MPH, OMS4, CD

• Speech-Language Pathologist in Lilburn, GA
• Providers in Lilburn, GA by specialty
• Speech-Language Pathologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.