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General NPI Number Information
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NPI Number | 1447473038
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Entity Type | Individual
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Provider Name | MICHAEL DEWITT HARRISON PHD
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Gender | Male
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Dates
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Enumeration Date | 04/11/2007
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Last Update Date | 01/03/2022
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Provider Practice Location Address
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Address Line | 1501 CROCKER ST SUITE 1
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City | HOUSTON
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State | TX
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Zip | 77019-4340
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Country | US
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Telephone | 713-504-7772
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Fax | 832-209-7290
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Provider Business Mailing Address
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Address Line | PO BOX 7353
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City | HOUSTON
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State | TX
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Zip | 77248-7353
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Country | US
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Telephone | 713-504-7772
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Fax | 832-209-7290
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 33283
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License Number State | TX
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