Individual
ALETHA GAIL HARRIS-PAULK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1940 MARAVILLA AVE, FORT MYERS, FL 33901-7135
(239) 687-9960
Mailing address
PO BOX 60846, FORT MYERS, FL 33906-6846
(239) 687-9960
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
021352600
—
FL
Enumeration date
08/23/2017
Last updated
08/23/2017
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