Doctor Name: | DR. JOHN W. HARRIS |
NPI Number: | 1073735312 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PHD |
License Number: | 20010151A |
Business Practice Address: | 204 Lincolnway Valparaiso, IN - 463835644 |
Business Phone Number: | 2195310452 |
Business Fax Number: | |
Mailing Address: | 308 Calumet Ave, VALPARAISO |
State: | IN |
Postal Code: | 463834802 |
Phone Number: | 2194627141 |
Fax Number: | |
NPI Enumeration Date: | 05/03/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 20010151A |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IN |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |