MEDICARE: DR. AARON A 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
1	103TC0700X	Clinical Psychologist	2171	KS
2	103TC0700X	Clinical Psychologist	PSY-203086	ID

General Provider Information

NPI Number	:	1669480091
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AARON A HARRIS PHD

Provider Business Mailing Address
First Line	:	5272 LONG COVE DR
Second Line	:
City	:	IDAHO FALLS
State	:	ID
Zip	:	83404-8288
Country	:	US
Telephone Number	:	208-419-9238
Fax Number	:	208-598-7998

Provider Business Practice Location Address
First Line	:	1301 E 17TH ST
Second Line	:
City	:	IDAHO FALLS
State	:	ID
Zip	:	83404-6273
Country	:	US
Telephone Number	:	406-848-4906
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/03/2006
Last Update Date	:	01/17/2025

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Directions to “ DR. AARON A HARRIS PHD” Practice Location

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