MEDICARE: LAURIE CARRIN HARPER PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist

General Provider Information

NPI Number	:	1568615953
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURIE CARRIN HARPER PH.D.

Provider Business Mailing Address
First Line	:	300 W 19TH TER
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64108-2026
Country	:	US
Telephone Number	:	816-404-5991
Fax Number	:

Provider Business Practice Location Address
First Line	:	7300 N PERIMETER RD
Second Line	:
City	:	MALMSTROM AFB
State	:	MT
Zip	:	59402-6780
Country	:	US
Telephone Number	:	406-731-4451
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/29/2008
Last Update Date	:	09/26/2012

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