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General NPI Number Information
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NPI Number | 1659617322
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Entity Type | Organization
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Legal Business Name | DR.HARRY R. DAVIDSON, PHD LLC
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Dates
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Enumeration Date | 12/27/2012
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Last Update Date | 12/27/2012
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Provider Practice Location Address
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Address Line | 7219 E 17TH ST
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City | KANSAS CITY
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State | MO
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Zip | 64126-3202
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Country | US
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Telephone | 816-912-4248
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Fax |
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Provider Business Mailing Address
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Address Line | 7219 E 17TH ST
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City | KANSAS CITY
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State | MO
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Zip | 64126-3202
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Country | US
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Telephone | 816-912-4248
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Fax |
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST
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Name | DR. HARRY ROBERT DAVIDSON
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Credential | PHD
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Telephone | 816-912-4248
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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 | 00237
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License Number State | MO
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