Provider Demographics
NPI:1811319718
Name:HARRELL, LUTHER III
Entity type:Individual
Prefix:MR
First Name:LUTHER
Middle Name:
Last Name:HARRELL
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2441 TECH CENTER CT
Mailing Address - Street 2:STE. 104
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-0804
Mailing Address - Country:US
Mailing Address - Phone:702-560-1898
Mailing Address - Fax:702-974-1521
Practice Address - Street 1:2441 TECH CENTER CT
Practice Address - Street 2:STE. 104
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-0804
Practice Address - Country:US
Practice Address - Phone:702-560-1898
Practice Address - Fax:702-974-1521
Is Sole Proprietor?:No
Enumeration Date:2014-01-10
Last Update Date:2014-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst