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NPI 1568633436

NPI 1568633436 : BRIAN S HARPER M.A., LMHC, CCTP : MILTON, FL

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General NPI Number Information
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    NPI Number           |    1568633436
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    Entity Type          |    Individual 
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    Provider Name        |    BRIAN S HARPER M.A., LMHC, CCTP
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    03/18/2008
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    Last Update Date     |    04/01/2013
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Provider Practice Location Address
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    Address Line         |    5643 STEWART ST 
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    City                 |    MILTON
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    State                |    FL
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    Zip                  |    32570-4227
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    Country              |    US
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    Telephone            |    850-983-4455
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    5643 STEWART ST 
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    City                 |    MILTON
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    State                |    FL
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    Zip                  |    32570-4227
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    Country              |    US
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    Telephone            |    850-983-4455
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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        |    101YM0800X
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    Taxonomy Name        |    Mental Health Counselor
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    License Number       |    MH 11592
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    License Number State |    FL
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