Provider Demographics
NPI:1821054354
Name:HARRELL, JANET E (PHD)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:E
Last Name:HARRELL
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 1:2200 E RIVER RD
Mailing Address - Street 2:124
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85718-6514
Mailing Address - Country:US
Mailing Address - Phone:520-888-3228
Mailing Address - Fax:520-232-1355
Practice Address - Street 1:2200 E RIVER RD
Practice Address - Street 2:124
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85718-6514
Practice Address - Country:US
Practice Address - Phone:520-888-3228
Practice Address - Fax:520-232-1355
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-24
Last Update Date:2010-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ746103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist