Individual
MICHAEL J HARRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSW, PH.D
Contact information
Practice address
211 S WOODRUFF AVE, A4, IDAHO FALLS, ID 83401-4369
(208) 529-5548
(208) 529-5588
Mailing address
211 S WOODRUFF AVE, A4, IDAHO FALLS, ID 83401-4369
(208) 529-5548
(208) 529-5588
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-420
ID
Other
Enumeration date
01/10/2007
Last updated
10/07/2010
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