Doctor Name: | DESIRRAE ANDERSON-HARRIS |
NPI Number: | 1104208917 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW-A |
License Number: | P008677 |
Business Practice Address: | 120 Stonehurst Dr Spring Lake, NC - 283906017 |
Business Phone Number: | 9105804357 |
Business Fax Number: | |
Mailing Address: | 120 Stonehurst Dr, SPRING LAKE |
State: | NC |
Postal Code: | 283906017 |
Phone Number: | 9105804357 |
Fax Number: | |
NPI Enumeration Date: | 06/29/2015 |
NPI Last Update Date: | 06/29/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | P008677 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |