| Ted A. Harris, Phd, Licensed Psychologist, Inc. | |
|
5691 S Redwood Rd # 16 Taylorsville UT 84123-5322 | |
| (801) 265-3895 | |
| (801) 263-1265 |
| Full Name | Ted A. Harris, Phd, Licensed Psychologist, Inc. |
|---|---|
| Speciality | Psychologist |
| Location | 5691 S Redwood Rd # 16, Taylorsville, Utah |
| Authorized Official Name and Position | Ted A Harris (PSYCHOLOGIST) |
| Authorized Official Contact | 8012653895 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ted A. Harris, Phd, Licensed Psychologist, Inc. 5691 S Redwood Rd # 16 Taylorsville UT 84123-5322 Ph: (801) 265-3895 | Ted A. Harris, Phd, Licensed Psychologist, Inc. 5691 S Redwood Rd # 16 Taylorsville UT 84123-5322 Ph: (801) 265-3895 |
| NPI Number | 1487768826 |
|---|---|
| Provider Enumeration Date | 08/19/2006 |
| Last Update Date | 11/24/2008 |
| Medicare PECOS PAC ID | 5890608236 |
|---|---|
| Medicare Enrollment ID | O20031111000369 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487768826 | NPI | - | NPPES |
| 52806017403001 | Other | UT | BCBS OF UTAH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 91-116205-2501 (Utah) | Primary |
| Provider Name | Ted A Harris |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1033186382 PECOS PAC ID: 9032022819 Enrollment ID: I20091105000509 |
Janet E. Hooper, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 5689 S Redwood Rd, #28-2, Taylorsville, UT 84123 Phone: 801-266-4643 Fax: 801-266-4775 | |
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