Jaclyn N Harris, MS,CCC-SLP

Individual provider Active NPI Speech-Language Pathologist · Humble, TX

NPI 1306150065 · NPPES record last updated Aug 4, 2010

Key facts

NPI
1306150065
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
101608 (TX)
Practice address
19100 W Lake Houston Pkwy Ste 104
Humble, TX 77346-5139
Phone
(281) 812-9519
Fax
(281) 812-5719
NPI assigned
Aug 4, 2010
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
101608TXMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Achieve Speech and Language Services PLLC Speech-Language Pathologist Past
since Aug 1, 2019
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 101608 TX Yes

Addresses

Primary practice location

19100 W Lake Houston Pkwy Ste 104
Humble, TX 77346-5139

Mailing address

17503 Bryce Manor LN
Humble, TX 77346-6216
Phone (281) 812-9519

Other providers in Humble, TX

All providers in Humble, TX · Speech-Language Pathologist in Texas

Sources for this page

Verify at the official NPI Registry.