Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | LC9999 | MD |
NPI | 1003215575 |
---|---|
Provider Name | Stella Kamille Janell Harris |
First Address | Hagerstown, MD 21742-7505 |
Second Address | Bel Air, MD 21014-3978 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/08/2014 |
Last Update Date | 09/06/2020 |