Individual
ANGELA HARRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4064 RACE TRACK RD, GRIFTON, NC 28530-7304
(252) 523-4687
Mailing address
4064 RACE TRACK RD, GRIFTON, NC 28530-7304
(252) 523-4687
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
21642A
NC
1041C0700X
Clinical Social Worker
Primary
P009384
NC
Other
Enumeration date
03/12/2015
Last updated
09/15/2016
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