Provider Demographics
NPI:1508335464
Name:HARRIS, CLARETHA (DIRECTOR OF PROGRAMS)
Entity Type:Individual
Prefix:
First Name:CLARETHA
Middle Name:
Last Name:HARRIS
Suffix:
Gender:F
Credentials:DIRECTOR OF PROGRAMS
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 611385
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33261-1385
Mailing Address - Country:US
Mailing Address - Phone:305-780-9205
Mailing Address - Fax:
Practice Address - Street 1:71 NE 187TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33179-4413
Practice Address - Country:US
Practice Address - Phone:305-780-9205
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-20
Last Update Date:2018-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor