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General NPI Number Information
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NPI Number | 1780488353
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Entity Type | Individual
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Provider Name | MERCEDES HARRISON
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Gender | Female
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Dates
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Enumeration Date | 04/02/2025
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Last Update Date | 04/02/2025
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Provider Practice Location Address
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Address Line | 14317 ITALIA DR
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City | WIMAUMA
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State | FL
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Zip | 33598-2101
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Country | US
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Telephone | 813-416-1519
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Fax |
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Provider Business Mailing Address
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Address Line | 10226 SUMMERVIEW CIR
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City | RIVERVIEW
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State | FL
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Zip | 33578-7551
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Country | US
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Telephone |
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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 | MH25469
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License Number State | FL
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