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General NPI Number Information
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NPI Number | 1174845127
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Entity Type | Individual
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Provider Name | HARLAN ROSS AUSTIN PH.D.
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Gender | Male
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Dates
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Enumeration Date | 02/18/2010
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Last Update Date | 05/13/2022
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Provider Practice Location Address
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Address Line | 50 BUCK CREEK RD STE 200
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City | AVON
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State | CO
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Zip | 81620-5428
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Country | US
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Telephone | 970-926-6340
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Fax | 970-926-6348
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Provider Business Mailing Address
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Address Line | 1693 QUENTIN ST CEDAR
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City | AURORA
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State | CO
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Zip | 80045-2518
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Country | US
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Telephone | 720-848-3078
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Fax | 720-848-3015
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 0004247
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License Number State | CO
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