Individual
KELLI BRYANT HARRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
394 TIMBER LN, HUNTINGDON, TN 38344-1621
(731) 358-3356
Mailing address
PO BOX 41, HUNTINGDON, TN 38344-0041
(731) 358-5536
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0000006123
TN
1041C0700X
Clinical Social Worker
0904008341
VA
1041C0700X
Clinical Social Worker
9034
MS
1041C0700X
Clinical Social Worker
CSW004625
GA
Other
Enumeration date
01/10/2014
Last updated
03/17/2018
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