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NPI Code Detail

MEDICARE: KODY HARMS

MEDICARE:   KODY  HARMS
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1942717061
Entity Type Code : Individual
Provider Name (Legal Business Name) : KODY HARMS
Provider Business Mailing Address
First Line : 1230 ROSECRANS AVE STE 250
Second Line :
City : MANHATTAN BEACH
State : CA
Zip : 90266-2496
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1230 ROSECRANS AVE STE 250
Second Line :
City : MANHATTAN BEACH
State : CA
Zip : 90266-2496
Country : US
Telephone Number : 310-721-9699
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/10/2018
Last Update Date : 01/10/2018

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Directions to “ KODY HARMS ” Practice Location

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