Individual
MR. WILLIE CLARENCE HARRIS IV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LOTR
Contact information
Practice address
625 BELLINGRATH LN, SLIDELL, LA 70458-2262
(504) 931-8067
Mailing address
625 BELLINGRATH LN, SLIDELL, LA 70458-2262
(504) 931-8067
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTT.200561
LA
Other
Enumeration date
02/15/2021
Last updated
02/15/2021
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