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General NPI Number Information
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NPI Number | 1427466374
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Entity Type | Organization
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Legal Business Name | MEREDITH HARRIS LLC
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Dates
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Enumeration Date | 07/23/2014
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Last Update Date | 02/04/2016
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Provider Practice Location Address
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Address Line | 13670 METROPOLIS AVE 101
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City | FORT MYERS
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State | FL
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Zip | 33912-4346
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Country | US
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Telephone | 504-615-7217
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Fax | 239-674-0304
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Provider Business Mailing Address
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Address Line | 13670 METROPOLIS AVE 101
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City | FORT MYERS
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State | FL
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Zip | 33912-4346
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Country | US
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Telephone | 504-615-7217
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Fax | 239-674-0304
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Authorized Official
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Title or Position | CLINICAL SOCIAL WORKER
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Name | MS. MEREDITH WHEELER HARRIS
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Credential | MSW,LCSW,SAP
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Telephone | 504-615-7217
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SW13128
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License Number State | FL
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