Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | MH10459 | FL |
NPI | 1003189549 |
---|---|
Provider Name | Miss Jennifer Harrison |
First Address | Miami, FL 33136-1409 |
Second Address | Miami, FL 33136-1409 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/02/2012 |
Last Update Date | 14/02/2012 |