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General NPI Number Information
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NPI Number | 1740133503
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Entity Type | Organization
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Legal Business Name | HARVEST AUTISM & BEHAVIORAL HEALTH PLLC
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Dates
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Enumeration Date | 02/19/2026
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Last Update Date | 02/19/2026
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Provider Practice Location Address
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Address Line | 4 LAKEVIEW RD
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City | COLUMBIA
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State | MS
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Zip | 39429-9721
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Country | US
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Telephone | 601-441-4307
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Fax |
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Provider Business Mailing Address
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Address Line | 338 RAYNES RD
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City | CARSON
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State | MS
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Zip | 39427-6366
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Country | US
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Telephone | 601-441-4307
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Fax | 601-441-4307
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Authorized Official
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Title or Position | MANAGER
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Name | SHANNOON WILLIS
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Credential |
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Telephone | 601-441-4307
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD1600X
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Taxonomy Name | Developmental Disabilities Clinic/Center
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License Number |
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License Number State |
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