Individual
MARTHA HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
925 HWY V V, KENNETT, MO 63857
(573) 888-5925
(573) 888-9365
Mailing address
PO BOX 71, KENNETT, MO 63857-0071
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
2003006630
MO
Other
Enumeration date
05/02/2008
Last updated
05/02/2008
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