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General NPI Number Information
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NPI Number | 1730347980
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Entity Type | Organization
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Legal Business Name | GORDON A HARRIS PH D & ASSOCIATES INC
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Dates
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Enumeration Date | 05/23/2008
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Last Update Date | 10/10/2024
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Provider Practice Location Address
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Address Line | 5400 N MAIN ST
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City | DAYTON
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State | OH
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Zip | 45415-3453
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Country | US
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Telephone | 937-274-2226
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Fax | 937-274-2074
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Provider Business Mailing Address
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Address Line | 5400 N MAIN ST
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City | DAYTON
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State | OH
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Zip | 45415-3453
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Country | US
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Telephone | 937-274-2226
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Fax | 937-274-2074
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | JENNIFER THOMPSON
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Credential |
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Telephone | 937-274-2226
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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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