Individual
W YVONNE HARRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5809 TWIN BROOK DR, CHARLOTTE, NC 28269-1691
(704) 302-7763
Mailing address
PO BOX 38313, CHARLOTTE, NC 28278-1005
(704) 302-7763
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
457232
NC
Other
Enumeration date
01/11/2008
Last updated
01/11/2008
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