1417184615 NPI number — DR. SHERYL WHALEN HARRISON PH.D.

Table of content: DR. SHERYL WHALEN HARRISON PH.D. (NPI 1417184615)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1417184615 NPI number — DR. SHERYL WHALEN HARRISON PH.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HARRISON
Provider First Name:
SHERYL
Provider Middle Name:
WHALEN
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PH.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1417184615
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/15/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
515 E CAREFREE HWY
Provider Second Line Business Mailing Address:
STE. 328
Provider Business Mailing Address City Name:
PHOENIX
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85085-8839
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
480-483-9066
Provider Business Mailing Address Fax Number:
623-465-1556

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6609 N SCOTTSDALE RD
Provider Second Line Business Practice Location Address:
STE 103
Provider Business Practice Location Address City Name:
SCOTTSDALE
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85250-7801
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
480-483-9066
Provider Business Practice Location Address Fax Number:
623-465-1556
Provider Enumeration Date:
06/15/2009

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103T00000X , with the licence number:  822 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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