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Individual

CAITLIN M HARLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
1310 GOODMAN RD E, SOUTHAVEN, MS 38671-9542
(662) 470-5433
(501) 745-2378
Mailing address
1310 GOODMAN RD E, SOUTHAVEN, MS 38671-9542
(662) 470-5433
(501) 745-2378

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C9867
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
C9867
LCSW LICENSE
MS
Enumeration date
07/20/2022
Last updated
08/17/2022
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