Individual
MARY HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
601 W 18TH ST, AUSTIN, TX 78701-1111
(512) 420-8394
Mailing address
4903 SHOAL CREEK BLVD, AUSTIN, TX 78756-2521
(512) 420-8394
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
51059
TX
Other
Enumeration date
12/03/2012
Last updated
12/03/2012
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