Provider Demographics
NPI:1518362300
Name:HARRIS JUSTICE, ANGELA CHRISTIN (BSW)
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:CHRISTIN
Last Name:HARRIS JUSTICE
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:CRISSY
Other - Last Name:HARRIS JUSTICE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2409 HOMER CLAYTON DR
Mailing Address - Street 2:
Mailing Address - City:GUNTERSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35976-2207
Mailing Address - Country:US
Mailing Address - Phone:256-582-4240
Mailing Address - Fax:256-582-4161
Practice Address - Street 1:2409 HOMER CLAYTON DR
Practice Address - Street 2:
Practice Address - City:GUNTERSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35976-2207
Practice Address - Country:US
Practice Address - Phone:256-582-4240
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-23
Last Update Date:2014-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health