Provider Demographics
NPI:1730344243
Name:HARRIS, BRIGGETT
Entity type:Individual
Prefix:
First Name:BRIGGETT
Middle Name:
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 1:711 57TH AVE W
Mailing Address - Street 2:APT. 210
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34207-3662
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3639 CORTEZ RD W
Practice Address - Street 2:SUITE 224
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34210-3103
Practice Address - Country:US
Practice Address - Phone:941-321-1027
Practice Address - Fax:941-792-9880
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-23
Last Update Date:2008-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health