Provider Demographics
NPI:1962666495
Name:ANNE L. HARZEM, PH.D.,LLC
Entity Type:Organization
Organization Name:ANNE L. HARZEM, PH.D.,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:LAAJA
Authorized Official - Last Name:HARZEM
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:334-745-0923
Mailing Address - Street 1:2204 EXECUTIVE PARK DR
Mailing Address - Street 2:
Mailing Address - City:OPELIKA
Mailing Address - State:AL
Mailing Address - Zip Code:36801-6062
Mailing Address - Country:US
Mailing Address - Phone:334-745-0923
Mailing Address - Fax:334-745-2192
Practice Address - Street 1:2204 EXECUTIVE PARK DR
Practice Address - Street 2:
Practice Address - City:OPELIKA
Practice Address - State:AL
Practice Address - Zip Code:36801-6062
Practice Address - Country:US
Practice Address - Phone:334-745-0923
Practice Address - Fax:334-745-2192
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-14
Last Update Date:2008-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL451103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL071036Medicare UPIN