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Individual

ANTONETTE HARRIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
QMHP

Contact information

Practice address
1006 TRILOGY LOOP APT 302, SUFFOLK, VA 23435
(757) 235-1161
Mailing address
805 RIDLEY STREET, SUFFOLK, VA 23434
(757) 235-1161

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
0732000F884
VA
101YM0800X
Mental Health Counselor
Primary
0733001137
VA

Other

Enumeration date
01/06/2025
Last updated
01/06/2025
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