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Individual

EVAN HARRIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LCSW, LISW

Contact information

Practice address
100 19TH ST STE 102, ROCK ISLAND, IL 61201-8022
(309) 236-9553
Mailing address
PO BOX 51, PREEMPTION, IL 61276-0051
(309) 236-9553

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
008410
IA
1041C0700X
Clinical Social Worker
Primary
149.019633
IL

Other

Enumeration date
12/15/2017
Last updated
03/17/2018
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