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1720754229
TREVOR KYLE HARRIS
KENOSHA, WI
NPI
1720754229
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
235Z00000X Speech-Language Pathologist,
(Licence: WI 4545154)
Enumeration Date
2021-08-17
Last Update Date
2024-11-04
Business Address
TREVOR KYLE HARRIS CCC-SLP
7610 PERSHING BLVD
KENOSHA, WI 53142-4318
Phone number: 262-948-3600
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Mailing Address
TREVOR KYLE HARRIS CCC-SLP
PO BOX 735044
CHICAGO, IL 60673-5044
Phone number: 800-326-2250
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