Provider Demographics
NPI:1356471965
Name:HARDER MEDICAL, INC.
Entity Type:Organization
Organization Name:HARDER MEDICAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:HARDER
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:702-685-5297
Mailing Address - Street 1:4955 S. DURANGO DR.
Mailing Address - Street 2:SUITE 214
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89113-0157
Mailing Address - Country:US
Mailing Address - Phone:702-685-5297
Mailing Address - Fax:702-685-5314
Practice Address - Street 1:4955 S. DURANGO DR.
Practice Address - Street 2:SUITE 214
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89113-0157
Practice Address - Country:US
Practice Address - Phone:702-685-5297
Practice Address - Fax:702-685-5314
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2012-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVPY0338103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV002602054Medicaid
NV002602054Medicaid