Individual
MRS. ANGELA POWELL HARRISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BS
Contact information
Practice address
3407 SHAMROCK CT, GAUTIER, MS 39553-5337
(228) 497-0690
(228) 497-1363
Mailing address
3407 SHAMROCK CT, GAUTIER, MS 39553-5337
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00018214
—
MS
Enumeration date
06/17/2014
Last updated
06/17/2014
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