Provider Demographics
NPI:1003327354
Name:HARMAN, MARY SUE (LCPM)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:SUE
Last Name:HARMAN
Suffix:
Gender:F
Credentials:LCPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1906 MEATHOUSE FRK
Mailing Address - Street 2:
Mailing Address - City:CANADA
Mailing Address - State:KY
Mailing Address - Zip Code:41519-8245
Mailing Address - Country:US
Mailing Address - Phone:859-314-5655
Mailing Address - Fax:
Practice Address - Street 1:1906 MEATHOUSE FRK
Practice Address - Street 2:
Practice Address - City:CANADA
Practice Address - State:KY
Practice Address - Zip Code:41519-8245
Practice Address - Country:US
Practice Address - Phone:859-314-5655
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-13
Last Update Date:2023-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4000746176B00000X
176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife