Individual
MS. GWENETTA A HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BS
Contact information
Practice address
437 W PARKER ST, BAXLEY, GA 31513-0605
(912) 705-0858
(912) 705-6423
Mailing address
77 ALVIN OGDEN DR, BAXLEY, GA 31513-8883
(912) 339-1423
(912) 705-6423
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC008226
GA
Other
Enumeration date
03/15/2019
Last updated
06/11/2019
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