Doctor Name: | MRS. HEATHER L HARRISON |
NPI Number: | 1063793040 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC |
License Number: | 4138 |
Business Practice Address: | 229 W Gentry Ave Checotah, OK - 744262439 |
Business Phone Number: | 9184731575 |
Business Fax Number: | |
Mailing Address: | 617 Hilltop Ln, MUSKOGEE |
State: | OK |
Postal Code: | 744037534 |
Phone Number: | 9186366663 |
Fax Number: | |
NPI Enumeration Date: | 09/02/2011 |
NPI Last Update Date: | 09/02/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 4138 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OK |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |