Individual
ANITA B HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CASAC-T
Contact information
Practice address
22 OLD CANAL DR, LOWELL, MA 01851-2730
(978) 452-5155
Mailing address
22 OLD CANAL DR, LOWELL, MA 01851-2730
(978) 452-5155
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1023175072
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1023175072
—
MA
05
—
205054049
—
MA
Enumeration date
10/24/2016
Last updated
10/24/2016
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