Provider Demographics
NPI:1083820344
Name:HARRISON, THOMAS COLLINS JR (PHD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:COLLINS
Last Name:HARRISON
Suffix:JR
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2577 ROMAN DR
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89434-2113
Mailing Address - Country:US
Mailing Address - Phone:775-359-5222
Mailing Address - Fax:775-784-1990
Practice Address - Street 1:2577 ROMAN DR
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89434-2113
Practice Address - Country:US
Practice Address - Phone:775-359-5222
Practice Address - Fax:775-784-1990
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV0793106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist