Provider Demographics
NPI:1043072945
Name:HARANO, TYLER
Entity Type:Individual
Prefix:
First Name:TYLER
Middle Name:
Last Name:HARANO
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 1:4490 ELDORADO PKWY APT 528
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-3880
Mailing Address - Country:US
Mailing Address - Phone:805-416-6760
Mailing Address - Fax:
Practice Address - Street 1:201 W NORTH RIVER DR STE 301
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-2262
Practice Address - Country:US
Practice Address - Phone:509-903-0103
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-25
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX204962106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist