Individual
DEMETRIA HARRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
455 N. MESA DRIVE #11, MESA, AZ 85201
(480) 262-3848
(480) 668-3439
Mailing address
455 N MESA DR STE 11, MESA, AZ 85201-5936
(480) 207-7560
(480) 668-3439
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
OTC6493
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OTC6493
ARIZONA DEPARTMENT OF HEALTH SERVICES
AZ
Enumeration date
09/25/2014
Last updated
09/25/2014
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