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General NPI Number Information
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NPI Number | 1669480091
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Entity Type | Individual
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Provider Name | AARON A HARRIS PHD
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Gender | Male
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Dates
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Enumeration Date | 08/03/2006
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Last Update Date | 01/17/2025
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Provider Practice Location Address
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Address Line | 1301 E 17TH ST
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City | IDAHO FALLS
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State | ID
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Zip | 83404-6273
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Country | US
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Telephone | 406-848-4906
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Fax |
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Provider Business Mailing Address
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Address Line | 5272 LONG COVE DR
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City | IDAHO FALLS
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State | ID
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Zip | 83404-8288
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Country | US
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Telephone | 208-419-9238
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Fax | 208-598-7998
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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 | 2171
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY-203086
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License Number State | ID
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