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NPI Code Detail

MEDICARE: DR. GARY CHANNING HARRIS PHD

MEDICARE: DR. GARY CHANNING HARRIS PHD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical PsychologistPSY.0004758CO

General Provider Information

NPI Number : 1043733975
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GARY CHANNING HARRIS PHD
Provider Business Mailing Address
First Line : 2121 NORTH AVE
Second Line :
City : GRAND JUNCTION
State : CO
Zip : 81501-6428
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2121 NORTH AVE
Second Line :
City : GRAND JUNCTION
State : CO
Zip : 81501-6428
Country : US
Telephone Number : 970-244-1326
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/23/2017
Last Update Date : 03/06/2026

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