Provider Demographics
NPI:1043027568
Name:HARRIS, HALEY SAMANTHA
Entity type:Individual
Prefix:
First Name:HALEY
Middle Name:SAMANTHA
Last Name:HARRIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:HALEY
Other - Middle Name:
Other - Last Name:THOMPSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:14930 MUESCHKE RD STE 100
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433-0980
Mailing Address - Country:US
Mailing Address - Phone:346-206-3992
Mailing Address - Fax:
Practice Address - Street 1:14930 MUESCHKE RD STE 100
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77433-0980
Practice Address - Country:US
Practice Address - Phone:346-206-3992
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-17
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1091561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical