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Individual

ALISSA RAE HARRIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LBA, LMHC

Contact information

Practice address
161 S WAKEA AVE, KAHULUI, HI 96732-1343
(808) 244-7467
Mailing address
1102 MOLE PL, MAKAWAO, HI 96768-9349
(808) 868-9536

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
MHC-845
HI
103K00000X
Behavior Analyst
Primary
227
HI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1922870302
HI
Enumeration date
04/11/2018
Last updated
12/12/2023
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