Individual
MR. CHARLES HARRIS SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1230 MAGNOLIA DALE DR, FRESNO, TX 77545-9680
(832) 474-0812
(281) 888-3675
Mailing address
1230 MAGNOLIA DALE DRIVE, FRESNO, TX 77545
(832) 474-0812
(281) 888-3675
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
35131
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
156608503
—
TX
05
—
156608504
—
TX
Enumeration date
08/11/2006
Last updated
06/17/2011
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