Harris, Penny Long

Harris, Penny Long is an individual health care provider with primary practice located at 3220 Highway 112 , Camilla GA 31730-4750. She recently has only one registered license in Speech, Language and Hearing Service Providers / Speech-Language Pathologist, which is considered as her primary health care specialty. Harris, Penny Long can be contacted via phone (229) 336-0742.

Contact Information

Primary practice address
3220 Highway 112 Camilla GA 31730-4750
Phone: (229) 336-0742
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X 003443 Georgia

Profile Details

NPI number 1427094622
LBN Legal business name Harris, Penny Long
Credentials M. ED., CCC-SLP
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 22nd, 2006
Last updated Mar 18th, 2013 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1427094622 NPPES
Georgia MEDICAID 00717417D

Popular Providers