Provider Demographics
NPI:1083022412
Name:HARROLD, ROBERT KORY
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:KORY
Last Name:HARROLD
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 1:10802 VEMOA DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89141-3836
Mailing Address - Country:US
Mailing Address - Phone:702-752-4246
Mailing Address - Fax:
Practice Address - Street 1:4425 S JONES BLVD
Practice Address - Street 2:#D3
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89103-3370
Practice Address - Country:US
Practice Address - Phone:702-991-3150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-29
Last Update Date:2014-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker