Individual
MRS. CYNTHIA RENE'A KING-HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.,L.M.H.C.
Contact information
Practice address
3603 E JEFFERSON BLVD, SOUTH BEND, IN 46615-3035
(574) 298-8931
Mailing address
PO BOX 6122, SOUTH BEND, IN 46660-6122
(574) 298-8931
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
39001737A
IN
104100000X
Social Worker
33001862A
IN
Other
Enumeration date
01/08/2009
Last updated
01/08/2009
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