Individual
MR. SHEVONTAE KENTRELL HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, MS
Contact information
Practice address
1642 E BARBERRY LN, MT PROSPECT, IL 60056-1512
(312) 650-5522
Mailing address
752 W 30TH ST, CHICAGO, IL 60616-3048
(773) 382-1315
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
11/03/2022
Last updated
11/03/2022
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