Provider Demographics
NPI:1033852546
Name:HARRIS, AARON JOSEPH
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:JOSEPH
Last Name:HARRIS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:387 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CANEY
Mailing Address - State:OK
Mailing Address - Zip Code:74533-3413
Mailing Address - Country:US
Mailing Address - Phone:405-723-1747
Mailing Address - Fax:
Practice Address - Street 1:387 W MAIN ST
Practice Address - Street 2:
Practice Address - City:CANEY
Practice Address - State:OK
Practice Address - Zip Code:74533-3413
Practice Address - Country:US
Practice Address - Phone:405-723-1747
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-14
Last Update Date:2022-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator