Individual
VIVIAN HARRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
—
—
251B00000X
Case Management Agency
Primary
—
WI
251S00000X
Community/Behavioral Health Agency
—
WI
320800000X
Mental Illness Community Based Residential Treatment Facility
—
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1407262678
—
WI
Enumeration date
07/08/2014
Last updated
04/16/2021
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