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General NPI Number Information
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NPI Number | 1295750636
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Entity Type | Individual
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Provider Name | JOHN ROBERT HARRISON PHD
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Gender | Male
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Dates
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Enumeration Date | 07/13/2006
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Last Update Date | 04/20/2025
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Provider Practice Location Address
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Address Line | 601 W SPRUCE ST STE K
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City | MISSOULA
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State | MT
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Zip | 59802-4047
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Country | US
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Telephone | 406-327-3330
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Fax | 406-327-2399
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Provider Business Mailing Address
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Address Line | PO BOX 31001-4110
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City | PASADENA
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State | CA
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Zip | 91110-4110
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Country | US
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Telephone | 406-327-3330
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Fax | 406-327-2399
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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 | PSY-PSY-LIC-226
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License Number State | MT
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Taxonomy #2
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | 59040
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License Number State | MT
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Taxonomy #3
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | PSY-PSY-LIC-226
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License Number State | MT
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