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NPI Code Detail

MEDICARE: MRS. MYRA E HARRIS LCSW

MEDICARE: MRS. MYRA E HARRIS LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker34007124AIN

General Provider Information

NPI Number : 1497099980
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MYRA E HARRIS LCSW
Provider Business Mailing Address
First Line : PO BOX 769
Second Line :
City : JASPER
State : IN
Zip : 47547-0769
Country : US
Telephone Number : 812-482-3020
Fax Number : 812-482-6409
Provider Business Practice Location Address
First Line : 1443 9TH ST
Second Line :
City : TELL CITY
State : IN
Zip : 47586-1407
Country : US
Telephone Number : 812-547-7905
Fax Number : 812-547-5146
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/21/2012
Last Update Date : 02/18/2015

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Directions to “ MRS. MYRA E HARRIS LCSW” Practice Location

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