Provider Demographics
NPI:1366689689
Name:HARVAT, ALISON RENEE (LLPC)
Entity Type:Individual
Prefix:MRS
First Name:ALISON
Middle Name:RENEE
Last Name:HARVAT
Suffix:
Gender:F
Credentials:LLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6130 COCHISE DR
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48322-2361
Mailing Address - Country:US
Mailing Address - Phone:248-752-5080
Mailing Address - Fax:
Practice Address - Street 1:517 JACOB WAY
Practice Address - Street 2:#104
Practice Address - City:ROCHESTER
Practice Address - State:MI
Practice Address - Zip Code:48307-2299
Practice Address - Country:US
Practice Address - Phone:248-659-8034
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-08
Last Update Date:2009-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst