Doctor Name: | MS. JANISE HARRIS |
NPI Number: | 1003253642 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMSW |
License Number: | 1267959 |
Business Practice Address: | 1039 Maple Leaf Dr Mcdonough, GA - 302538042 |
Business Phone Number: | 6784990443 |
Business Fax Number: | |
Mailing Address: | 1039 Maple Leaf Dr, MCDONOUGH |
State: | GA |
Postal Code: | 302538042 |
Phone Number: | 6784990443 |
Fax Number: | |
NPI Enumeration Date: | 05/22/2013 |
NPI Last Update Date: | 05/22/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041S0200X |
License Number: | 1267959 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | GA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | School |
Taxonomy Definition: |