Individual
CHARLES MARVELLE HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
890 NORTHWOODS PLAZA, MACON, GA 31204
(478) 330-7164
(478) 330-7167
Mailing address
890 BURRUS RD, MACON, GA 31204-1441
(478) 330-7164
(478) 330-7167
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
08/12/2020
Last updated
08/12/2020
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