NPI: 1396021150
Provider Name: HIAWATHA HARRIS, CORPORATION
Doing Business As: PATHWAYS TO WELLNESS, MEDICATION CLINIC
Classification: Psychologist - 103TP0016X
Entity Type: Organization
Specialization: Prescribing (Medical)
Address:
509 W 10TH ST
ANTIOCH, CA
ZIP 94509
Phone: (925) 706-1510
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HIAWATHA HARRIS, CORPORATION is a prescribing (medical) psychologist in Antioch, CA. The provider is a licensed, doctoral-level psychologist authorized to prescribe and has undergone specialized education and training in preparation for prescriptive practice and has passed an examination accepted by the state board of psychology relevant to establishing competence for prescribing, and has received from the state board of psychology a current certificate granting prescriptive authority, which has not been revoked or suspended. HIAWATHA HARRIS, CORPORATION NPI is 1396021150. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Pathways To Wellness, Medication Clinic.
The provider's business location address is:
509 W 10TH ST
ANTIOCH, CA
ZIP 94509-653
Phone: (925) 706-1510
Fax: (925) 892-9822
The provider's authorized official is Neisha Becton .
The authorized official title is Ceo and has the following contact phone number (925) 520-0005.
The enumeration date for this NPI number is 10/25/2011 and was last updated on 10/25/2011.