Provider Demographics
NPI:1629799572
Name:HARRON, ANDREW (PSYD, MBA)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:
Last Name:HARRON
Suffix:
Gender:M
Credentials:PSYD, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 CHESTNUT ST. SUITE 2 #1892
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19102-2700
Mailing Address - Country:US
Mailing Address - Phone:206-992-3339
Mailing Address - Fax:
Practice Address - Street 1:16 WILDWOOD AVE
Practice Address - Street 2:
Practice Address - City:MORTON
Practice Address - State:PA
Practice Address - Zip Code:19070-1916
Practice Address - Country:US
Practice Address - Phone:206-992-3339
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-08
Last Update Date:2022-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS019633103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist