Individual
MICAH DALE HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
200 PINE ST, SIKESTON, MO 63801-3258
(573) 472-8850
Mailing address
6738 STATE HIGHWAY 77, BENTON, MO 63736-8238
(573) 313-2500
(573) 313-2505
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2013009446
MO
Other
Enumeration date
03/30/2013
Last updated
03/12/2020
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