Provider Demographics
NPI:1699908350
Name:HARRELL, EMILIE ELIZABETH (BSW)
Entity type:Individual
Prefix:MISS
First Name:EMILIE
Middle Name:ELIZABETH
Last Name:HARRELL
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 151240
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92175-1240
Mailing Address - Country:US
Mailing Address - Phone:619-278-2400
Mailing Address - Fax:619-294-9405
Practice Address - Street 1:3990 OLD TOWN AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92110-2930
Practice Address - Country:US
Practice Address - Phone:619-278-2400
Practice Address - Fax:619-294-9405
Is Sole Proprietor?:No
Enumeration Date:2009-08-28
Last Update Date:2009-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker