Organization
JESSICA E HARRISON, LCSW
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JESSICA EMILY HARRISON LCSW (PRESIDENT)
(954) 600-6695
Entity
Organization
Contact information
Practice address
900 E INDIANTOWN RD STE 310, JUPITER, FL 33477-5153
(954) 600-6695
Mailing address
21000 PORTOFINO CIR APT 125, PALM BEACH GARDENS, FL 33418-1262
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
261QM2500X
Medical Specialty Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003790900
—
FL
Enumeration date
12/14/2018
Last updated
06/27/2019
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