Basic Information
| Provider Information | |||||||||
| NPI: | 1649315722 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HARRIS | ||||||||
| FirstName: | YOLANDA | ||||||||
| MiddleName: | MICHELLE | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | L.P.C. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5540 TECH CENTER DR | ||||||||
| Address2: | SUITE 203 | ||||||||
| City: | COLORADO SPRINGS | ||||||||
| State: | CO | ||||||||
| PostalCode: | 809192331 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7195480100 | ||||||||
| FaxNumber: | 7195480616 | ||||||||
| Practice Location | |||||||||
| Address1: | 5540 TECH CENTER DR | ||||||||
| Address2: | SUITE 203 | ||||||||
| City: | COLORADO SPRINGS | ||||||||
| State: | CO | ||||||||
| PostalCode: | 809192331 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7195480100 | ||||||||
| FaxNumber: | 7195480616 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/20/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | CO | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.