Provider Demographics
NPI:1881338259
Name:HARRISON, MADELINE (AUD)
Entity type:Individual
Prefix:DR
First Name:MADELINE
Middle Name:
Last Name:HARRISON
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:898 W JUNIPER AVE
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85233-4236
Mailing Address - Country:US
Mailing Address - Phone:253-548-7862
Mailing Address - Fax:
Practice Address - Street 1:10238 E HAMPTON AVE STE 402
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85209-3319
Practice Address - Country:US
Practice Address - Phone:602-956-1250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-22
Last Update Date:2022-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZDA13092231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist