Provider Demographics
NPI:1376856252
Name:HARRIS, KATHERINE MOORE (PHD)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:MOORE
Last Name:HARRIS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:KATE
Other - Middle Name:HARRIS
Other - Last Name:THUT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:383 CENTRAL AVE STE 261
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:NH
Mailing Address - Zip Code:03820-6422
Mailing Address - Country:US
Mailing Address - Phone:603-970-1889
Mailing Address - Fax:
Practice Address - Street 1:383 CENTRAL AVE STE 261
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:NH
Practice Address - Zip Code:03820-6422
Practice Address - Country:US
Practice Address - Phone:603-970-1889
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-20
Last Update Date:2022-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1195103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist