Doctor Name: | JUDITH DEBORAH HARRIS |
NPI Number: | 1083977763 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | R045174 DUP |
Business Practice Address: | 162-41 Powell's Cover Whitestone, NY - 11357 |
Business Phone Number: | 7187676567 |
Business Fax Number: | |
Mailing Address: | 162-41 Powell's Cover, WHITESTONE |
State: | NY |
Postal Code: | 11357 |
Phone Number: | 7187676567 |
Fax Number: | |
NPI Enumeration Date: | 06/19/2012 |
NPI Last Update Date: | 06/21/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | R045174 DUP |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |