Provider Demographics
NPI:1790855294
Name:HARRIS, MARCI W (PHD)
Entity Type:Individual
Prefix:DR
First Name:MARCI
Middle Name:W
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 1:6609 N SCOTTSDALE RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85250-7801
Mailing Address - Country:US
Mailing Address - Phone:480-948-0119
Mailing Address - Fax:480-948-9411
Practice Address - Street 1:6609 N SCOTTSDALE RD
Practice Address - Street 2:SUITE 103
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85250-7801
Practice Address - Country:US
Practice Address - Phone:480-948-0119
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAZ1488103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZR86402Medicare UPIN