Provider Demographics
NPI:1609046614
Name:HARDER, GREGORY SCOTT (PSYD)
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:SCOTT
Last Name:HARDER
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9510 W SAHARA AVE STE 110
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-8804
Mailing Address - Country:US
Mailing Address - Phone:702-685-5297
Mailing Address - Fax:702-685-5314
Practice Address - Street 1:9510 W SAHARA AVE STE 110
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-8804
Practice Address - Country:US
Practice Address - Phone:702-685-5297
Practice Address - Fax:702-685-5314
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-05
Last Update Date:2017-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVPY0338103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical