Provider Information for 1538499603
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QUINTINA SHAMIKA HARRIS LCSW, MCAP
Sex: Female
NPI: 1538499603
Last Updated: 2023-03-09
Certification Date: 2023-03-09
Certification Date: 2023-03-09
Details
| Name | Value | ||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1538499603 | ||||||||||||||||
| Enumeration Date | 2010-01-12 | ||||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||||
| Sole Proprietor | NO | ||||||||||||||||
| Status | Active | ||||||||||||||||
| Mailing Address | 4710 NE SAVANNAH RD JENSEN BEACH, FL 34957-3746 United States Phone: 772-940-1533 | Fax: | ||||||||||||||||
| Primary Practice Address | 10542 S US HIGHWAY 1 PORT ST LUCIE, FL 34952-5603 United States Phone: 772-940-1533 | Fax: | ||||||||||||||||
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