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Organization
HIAWATHA HARRIS, CORPORATION
Active
Organization
HIAWATHA HARRIS, CORPORATION
Active
Other names
Pathways to Wellness, Medication Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NEISHA BECTON (CEO)
(925) 520-0005
Entity
Organization
Contact information
Practice address
1453 FIRST ST, LIVERMORE, CA 94550-4203
(925) 520-0005
Mailing address
5674 STONERIDGE DR STE 116, PLEASANTON, CA 94588-8536
(925) 520-0005
(925) 520-0010
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
C22371
CA
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
C22371
CA
103TF0000X
Family Psychologist
C22371
CA
103TM1800X
Intellectual & Developmental Disabilities Psychologist
C22371
CA
106H00000X
Marriage & Family Therapist
C22371
CA
Other
Enumeration date
11/08/2010
Last updated
11/08/2010
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