Individual
ANDREW M HARRELL SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
11180 NE 38TH ST, JASPER, FL 32052-2502
(386) 792-6638
(386) 792-6401
Mailing address
10333 124TH ST, LIVE OAK, FL 32060-6958
(386) 362-6483
(386) 362-2079
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
MH 3789
FL
Other
Enumeration date
11/06/2006
Last updated
07/08/2007
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