Provider Demographics
NPI:1174282206
Name:HARR, BRAD R
Entity Type:Individual
Prefix:
First Name:BRAD
Middle Name:R
Last Name:HARR
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 1:1217 OLD VINES TRL
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46143-3412
Mailing Address - Country:US
Mailing Address - Phone:317-442-0534
Mailing Address - Fax:
Practice Address - Street 1:1217 OLD VINES TRL
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46143-3412
Practice Address - Country:US
Practice Address - Phone:317-442-0534
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-16
Last Update Date:2022-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst