Individual
KENNETH RODLE HARRIS III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
WOMACK ARMY MEDICAL CENTER 2817 REILLY ROAD, FORT BRAGG, NC 28310-0001
(910) 907-8697
Mailing address
2817 REILLY ST, FORT BRAGG, NC 28310-7324
(910) 907-8697
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
08/23/2019
Last updated
08/23/2019
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