Provider Demographics
NPI:1760036743
Name:HARRIS, ADRIENNE P
Entity Type:Individual
Prefix:
First Name:ADRIENNE
Middle Name:P
Last Name:HARRIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:126 HIGHLAND ST
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29730-5902
Mailing Address - Country:US
Mailing Address - Phone:803-322-0235
Mailing Address - Fax:
Practice Address - Street 1:524 DOCTORS CT
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:SC
Practice Address - Zip Code:29706-8644
Practice Address - Country:US
Practice Address - Phone:803-581-8311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-29
Last Update Date:2019-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health