Individual
MS. CHANTIL HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A
Contact information
Practice address
4957 W FOND DU LAC AVE, MILWAUKEE, WI 53216-2324
(414) 873-1960
(414) 873-4990
Mailing address
4957 W FOND DU LAC AVE, MILWAUKEE, WI 53216-2324
(414) 873-1960
(414) 873-4990
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
3733-123
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39710900
—
WI
Enumeration date
12/26/2007
Last updated
12/27/2007
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