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Individual

FRED SUMNER HARRIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LCSW

Contact information

Practice address
896 HIGHWAY 441 S, CLAYTON, GA 30525-5423
(706) 782-5991
Mailing address
PO BOX 459, COLBERT, GA 30628-0459

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW006737
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
CSW006737
GA LICENSE
GA
Enumeration date
03/07/2007
Last updated
03/27/2019
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