=====================================================
General NPI Number Information
=====================================================
NPI Number | 1952055378
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | NATHAN HARRIS BCBA, LBA
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/04/2022
-----------------------------------------------------
Last Update Date | 01/27/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 540 W INTERNATIONAL AIRPORT RD
-----------------------------------------------------
City | ANCHORAGE
-----------------------------------------------------
State | AK
-----------------------------------------------------
Zip | 99518-1105
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 907-561-5335
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 540 W INTERNATIONAL AIRPORT RD
-----------------------------------------------------
City | ANCHORAGE
-----------------------------------------------------
State | AK
-----------------------------------------------------
Zip | 99518-1105
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 907-561-5335
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103K00000X
-----------------------------------------------------
Taxonomy Name | Behavior Analyst
-----------------------------------------------------
License Number | 249057
-----------------------------------------------------
License Number State | AK
-----------------------------------------------------