Provider Demographics
NPI:1417908781
Name:HARRIS, BARBARA (MED, EDS, LPC)
Entity Type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:
Last Name:HARRIS
Suffix:
Gender:F
Credentials:MED, EDS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1532
Mailing Address - Street 2:
Mailing Address - City:STATESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30459-1532
Mailing Address - Country:US
Mailing Address - Phone:912-489-5480
Mailing Address - Fax:912-764-4113
Practice Address - Street 1:315 MEADOWLARK CIR
Practice Address - Street 2:
Practice Address - City:STATESBORO
Practice Address - State:GA
Practice Address - Zip Code:30461-6973
Practice Address - Country:US
Practice Address - Phone:912-489-5480
Practice Address - Fax:912-764-4113
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA01866101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional