Individual
MR. JIM KEITH HARRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.C.S.W.
Contact information
Practice address
1834 CLAIRMONT RD, DECATUR, GA 30033-3405
(770) 242-2340
Mailing address
623 WENDAN DR, DECATUR, GA 30033-5550
(770) 242-2340
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW001491
GA
Other
Enumeration date
02/26/2007
Last updated
07/08/2007
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