Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor |
NPI | 1003011164 |
---|---|
Provider Name | Kimberly Harris |
First Address | Greeley, CO 80631-3835 |
Second Address | Greeley, CO 80631-3835 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/06/2007 |
Last Update Date | 13/03/2008 |