MEDICARE: DR. GEORGE BERNARD HAARMAN PSY.D.

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	KY#0706	KY

General Provider Information

NPI Number	:	1851381800
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GEORGE BERNARD HAARMAN PSY.D.

Provider Business Mailing Address
First Line	:	1400B BROWNS LN
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40207-4609
Country	:	US
Telephone Number	:	502-721-7522
Fax Number	:	502-721-7556

Provider Business Practice Location Address
First Line	:	1400B BROWNS LN
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40207-4609
Country	:	US
Telephone Number	:	502-721-7522
Fax Number	:	502-721-7556

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

Provider Enumeration Date	:	10/21/2005
Last Update Date	:	07/08/2007

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