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General NPI Number Information
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NPI Number | 1326749227
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Entity Type | Individual
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Provider Name | ANTOINE LAMAR HARRIS LGSW
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Gender | Male
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Dates
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Enumeration Date | 03/16/2023
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Last Update Date | 03/20/2023
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Provider Practice Location Address
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Address Line | 60 O ST NW
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City | WASHINGTON
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State | DC
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Zip | 20001-1259
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Country | US
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Telephone | 202-701-1200
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Fax |
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Provider Business Mailing Address
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Address Line | 3303 HUNTLEY SQUARE DR APT B2
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City | TEMPLE HILLS
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State | MD
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Zip | 20748-6206
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Country | US
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Telephone | 202-309-8689
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | LG50083098
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License Number State | DC
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