Individual
MICHELLE FULLER HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
39094 N ANGELLE CT, GONZALES, LA 70737
(225) 931-2653
(225) 677-8666
Mailing address
PO BOX 96, DUPLESSIS, LA 70728-0096
(225) 931-2653
(225) 677-8666
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
3757
LA
1041S0200X
School Social Worker
AN550373
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2486632
—
LA
Enumeration date
08/22/2017
Last updated
07/27/2020
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