Harris, Mya
Harris, Mya is an individual health care provider with primary practice located at 3040 N 117Th St , Wauwatosa WI 53222-4128. She recently has only one registered license in Behavioral Health & Social Service Providers / Social Worker, which is considered as her primary health care specialty. Harris, Mya can be contacted via phone (414) 479-9990.Contact Information
Primary practice address
3040 N 117Th St
Wauwatosa WI 53222-4128
Phone: (414) 479-9990
Fax: (414) 479-0230
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Social Worker | 104100000X | 8343-123 | Wisconsin |
Profile Details
| NPI number | 1053782003 |
|---|---|
| LBN Legal business name | Harris, Mya |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 16th, 2015 |
| Last updated | Nov 12th, 2021 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1053782003 | NPPES |
| Wisconsin | MEDICAID | 1053782003 |
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