Individual
CHARLES MICKEL HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2701 17TH ST, ROCK ISLAND, IL 61201-5351
(309) 779-2285
Mailing address
3470 N WILLOW CT APT 3, BETTENDORF, IA 52722-2872
(563) 357-6299
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
12/20/2017
Last updated
12/20/2017
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