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General NPI Number Information
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NPI Number | 1962666495
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Entity Type | Organization
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Legal Business Name | ANNE L. HARZEM, PH.D.,LLC
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Dates
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Enumeration Date | 07/14/2008
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Last Update Date | 07/17/2008
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Provider Practice Location Address
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Address Line | 2204 EXECUTIVE PARK DR
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City | OPELIKA
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State | AL
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Zip | 36801-6062
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Country | US
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Telephone | 334-745-0923
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Fax | 334-745-2192
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Provider Business Mailing Address
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Address Line | 2204 EXECUTIVE PARK DR
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City | OPELIKA
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State | AL
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Zip | 36801-6062
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Country | US
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Telephone | 334-745-0923
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Fax | 334-745-2192
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST
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Name | DR. ANNE LAAJA HARZEM
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Credential | PH.D.
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Telephone | 334-745-0923
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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 | 451
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License Number State | AL
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