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General NPI Number Information
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NPI Number | 1326653528
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Entity Type | Individual
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Provider Name | KELSEY HARRAGHY OD
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Gender | Female
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Dates
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Enumeration Date | 09/14/2020
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Last Update Date | 08/24/2023
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Provider Practice Location Address
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Address Line | 4745 N 7TH ST STE 145
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City | PHOENIX
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State | AZ
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Zip | 85014-3665
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Country | US
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Telephone | 602-265-8597
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Fax |
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Provider Business Mailing Address
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Address Line | 4745 N 7TH ST STE 145
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City | PHOENIX
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State | AZ
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Zip | 85014-3665
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Country | US
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Telephone | 602-265-8597
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Fax |
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPT-002459
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License Number State | AZ
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