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General NPI Number Information
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NPI Number | 1477784387
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Entity Type | Individual
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Provider Name | MR. JERMAINE HARRIS
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Gender | Male
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Dates
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Enumeration Date | 07/28/2009
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Last Update Date | 07/29/2009
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Provider Practice Location Address
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Address Line | 55 WESTCHESTER SQ
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City | BRONX
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State | NY
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Zip | 10461-3525
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Country | US
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Telephone | 718-931-4045
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Fax | 718-828-1329
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Provider Business Mailing Address
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Address Line | 2107 AMSTERDAM AVE APT 4A
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City | NEW YORK
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State | NY
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Zip | 10032-2508
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Country | US
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Telephone | 212-927-2944
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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