Provider Demographics
NPI:1699025197
Name:HARDER, ANN MARIE (BCBA)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:MARIE
Last Name:HARDER
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:ANN
Other - Middle Name:MARIE
Other - Last Name:MURPHY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:BCBA
Mailing Address - Street 1:7031 SCHEURER ST
Mailing Address - Street 2:
Mailing Address - City:PIGEON
Mailing Address - State:MI
Mailing Address - Zip Code:48755-9668
Mailing Address - Country:US
Mailing Address - Phone:989-963-0503
Mailing Address - Fax:
Practice Address - Street 1:7031 SCHEURER ST
Practice Address - Street 2:
Practice Address - City:PIGEON
Practice Address - State:MI
Practice Address - Zip Code:48755-9668
Practice Address - Country:US
Practice Address - Phone:989-963-0503
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-12
Last Update Date:2012-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-12-10189103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst