Provider Demographics
NPI:1114507282
Name:HARJO, ALEXANDRIA LOUISE
Entity Type:Individual
Prefix:MRS
First Name:ALEXANDRIA
Middle Name:LOUISE
Last Name:HARJO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:509 E HIGHWAY 33
Mailing Address - Street 2:
Mailing Address - City:PERKINS
Mailing Address - State:OK
Mailing Address - Zip Code:74059-4129
Mailing Address - Country:US
Mailing Address - Phone:405-547-2473
Mailing Address - Fax:
Practice Address - Street 1:509 E HIGHWAY 33
Practice Address - Street 2:
Practice Address - City:PERKINS
Practice Address - State:OK
Practice Address - Zip Code:74059-4129
Practice Address - Country:US
Practice Address - Phone:405-547-2473
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-12
Last Update Date:2021-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator