Doctor Name: | JILLIAN HARVISON |
NPI Number: | 1003285578 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC |
License Number: | 3409 |
Business Practice Address: | 7400 Roper Ln Daphne, AL - 365265274 |
Business Phone Number: | 2513786523 |
Business Fax Number: | |
Mailing Address: | 5750a Southland Dr, MOBILE |
State: | AL |
Postal Code: | 366933316 |
Phone Number: | 2513786523 |
Fax Number: | |
NPI Enumeration Date: | 09/15/2015 |
NPI Last Update Date: | 09/15/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 3409 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |