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General NPI Number Information
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NPI Number | 1710539408
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Entity Type | Organization
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Legal Business Name | BRYAN R HARRISON PHD PSYCHOLOGIST PC
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Dates
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Enumeration Date | 07/12/2019
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Last Update Date | 07/12/2019
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Provider Practice Location Address
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Address Line | 610 PITTSFORD VICTOR RD
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City | PITTSFORD
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State | NY
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Zip | 14534-3934
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Country | US
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Telephone | 585-662-5552
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Fax |
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Provider Business Mailing Address
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Address Line | 610 PITTSFORD VICTOR RD
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City | PITTSFORD
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State | NY
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Zip | 14534-3934
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Country | US
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Telephone | 585-662-5552
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Fax |
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DR. BRYAN HARRISON
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Credential | PHD
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Telephone | 443-756-9428
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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