Individual
LORETTA ANNETTE HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1823 GADSDEN ST, COLUMBIA, SC 29201-2344
(803) 779-5363
Mailing address
405 GREEN ROSE RD, COLUMBIA, SC 29229-9102
(803) 419-4241
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
CRC1092
SC
Other
Enumeration date
09/21/2007
Last updated
09/21/2007
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