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General NPI Number Information
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NPI Number | 1801005350
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Entity Type | Organization
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Legal Business Name | HARRIS MARRIAGE & FAMILY THERAPY INC
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Dates
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Enumeration Date | 05/22/2007
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Last Update Date | 07/14/2008
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Provider Practice Location Address
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Address Line | 731 N BEACH BLVD SUITE 209A
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City | LA HABRA
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State | CA
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Zip | 90631
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Country | US
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Telephone | 562-690-4060
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Fax | 562-690-8388
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Provider Business Mailing Address
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Address Line | 731 N BEACH BLVD SUITE 209A
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City | LA HABRA
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State | CA
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Zip | 90631
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Country | US
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Telephone | 562-690-4060
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Fax | 562-690-8388
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. SUSAN KOOYMAN HARRIS
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Credential | MA CCCSLP
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Telephone | 562-690-4060
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFC38440
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFC25622
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License Number State | CA
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