Individual
DEITRA HARRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
7700 ELLA JANE LN APT W, CHARLOTTE, NC 28273-4782
(704) 200-7983
Mailing address
7700 ELLA JANE LN APT W, CHARLOTTE, NC 28273-4782
(704) 200-7983
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C010735
NC
Other
Enumeration date
10/05/2018
Last updated
01/10/2020
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