Individual
ANTONETTE HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
916 N MOUNTAIN AVE STE A, UPLAND, CA 91786-3658
(909) 932-1069
Mailing address
916 N MOUNTAIN AVE STE A, UPLAND, CA 91786-3658
(909) 932-1069
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
02/01/2012
Last updated
02/01/2012
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