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General NPI Number Information
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NPI Number | 1609524768
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Entity Type | Individual
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Provider Name | ROBERT HARRIS
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Gender | Male
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Dates
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Enumeration Date | 03/16/2022
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Last Update Date | 03/16/2022
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Provider Practice Location Address
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Address Line | 2225 W MOUNTAIN VIEW RD STE 3
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City | PHOENIX
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State | AZ
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Zip | 85021-1811
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Country | US
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Telephone | 888-689-4325
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Fax |
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Provider Business Mailing Address
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Address Line | 740 W TUCKEY LN
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City | PHOENIX
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State | AZ
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Zip | 85013-1045
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Country | US
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Telephone | 888-689-4325
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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 | 103TA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Psychologist
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License Number |
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License Number State |
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