Individual
MR. MICHAEL DEWAYNE HARRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, LPC, NCC
Contact information
Practice address
612 PASTEUR DR, SUITE 106, GREENSBORO, NC 27403-1149
(336) 259-7201
Mailing address
7725 FORDING BRIDGE RD, KERNERSVILLE, NC 27284-6343
(336) 259-7201
(336) 595-8607
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
4911
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6102699
—
NC
Enumeration date
03/15/2007
Last updated
07/08/2007
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