Provider Demographics
NPI:1528469574
Name:HARRIS, CHRISTINE VIVIAN
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:VIVIAN
Last Name:HARRIS
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:CHRISTINE
Other - Middle Name:VIVIAN
Other - Last Name:HARRIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:2446 GREYWALL AVE
Mailing Address - Street 2:
Mailing Address - City:OCOEE
Mailing Address - State:FL
Mailing Address - Zip Code:34761-8965
Mailing Address - Country:US
Mailing Address - Phone:407-295-4573
Mailing Address - Fax:
Practice Address - Street 1:2446 GREYWALL AVE
Practice Address - Street 2:
Practice Address - City:OCOEE
Practice Address - State:FL
Practice Address - Zip Code:34761-8965
Practice Address - Country:US
Practice Address - Phone:407-295-4573
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-09
Last Update Date:2014-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor