Provider Demographics
NPI:1326202102
Name:HARLOR, MARK YOUCH (MED)
Entity Type:Individual
Prefix:MR
First Name:MARK
Middle Name:YOUCH
Last Name:HARLOR
Suffix:
Gender:M
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 N ACADEMY AVE
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17822-4243
Mailing Address - Country:US
Mailing Address - Phone:570-271-5040
Mailing Address - Fax:570-271-7806
Practice Address - Street 1:100 N ACADEMY AVE
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:PA
Practice Address - Zip Code:17822-4243
Practice Address - Country:US
Practice Address - Phone:570-271-5040
Practice Address - Fax:570-271-7806
Is Sole Proprietor?:No
Enumeration Date:2008-07-11
Last Update Date:2008-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL001182L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist