Individual
KANISHA HARRISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2680 GRADYS GROUND DR N, MC CONNELLS, SC 29726-6776
(803) 272-9645
Mailing address
2680 GRADYS GROUND DR N, MC CONNELLS, SC 29726-6776
(803) 272-9645
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
11303
SC
1041C0700X
Clinical Social Worker
CO12524
NC
Other
Enumeration date
09/14/2020
Last updated
09/14/2020
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