Provider Demographics
NPI:1578892501
Name:HARRIS, EMILY MERRILL (PHD)
Entity Type:Individual
Prefix:DR
First Name:EMILY
Middle Name:MERRILL
Last Name:HARRIS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2040 E MURRAY HOLLADAY RD STE 220
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84117-5123
Mailing Address - Country:US
Mailing Address - Phone:801-679-3225
Mailing Address - Fax:385-695-2407
Practice Address - Street 1:2040 E MURRAY HOLLADAY RD STE 220
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84117-5123
Practice Address - Country:US
Practice Address - Phone:801-679-3225
Practice Address - Fax:385-695-2407
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-22
Last Update Date:2020-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT3409042501103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical