Most Relevant Information
Provider Data
| NPI Number: | 1003679093 |
| Provider Name: | ANGEL ANTRELLE HARRIS |
| Entity Type: | Individual |
| Taxonomy Code: | 175T00000X |
| Specialty: | Peer Specialist |
| License Number: |
Most Important Dates
| Enumeration Date: | 02/01/2024 |
| Last Updated: | 08/09/2024 |
Provider Practice Location
235 CIVIC CENTER BLVD
HOUMA
LA
703605937
Practice Location Phone/Fax
| Phone: | 9858793966 |
| Fax: |
Provider Mailing Location
235 CIVIC CENTER BLVD
HOUMA
LA
703605937
Provider Mailing Phone/Fax
| Phone: | 9858793966 |
| Fax: |