Individual
CARL RAYE HARBISON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2210 BARRON RD STE 120, POPLAR BLUFF, MO 63901-1922
(573) 785-6536
(573) 785-0100
Mailing address
110 S 2ND ST, ELLINGTON, MO 63638-9400
(573) 663-2313
(573) 663-2441
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2018037840
MO
101YM0800X
Mental Health Counselor
Primary
—
MO
101YP2500X
Professional Counselor
2018037840
MO
Other
Enumeration date
10/05/2018
Last updated
06/17/2026
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