Provider Demographics
NPI:1427111475
Name:WAIN, HAROLD J (PHD)
Entity type:Individual
Prefix:DR
First Name:HAROLD
Middle Name:J
Last Name:WAIN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:9121 COPENHAVER DR
Mailing Address - Street 2:
Mailing Address - City:POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20854-3014
Mailing Address - Country:US
Mailing Address - Phone:301-279-2210
Mailing Address - Fax:202-782-8396
Practice Address - Street 1:WALTER REED ARMY MEDCIAL DEPT OF PSYCHIATRY CTR
Practice Address - Street 2:6900 GEORGIA AVE
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20307-0001
Practice Address - Country:US
Practice Address - Phone:202-782-9949
Practice Address - Fax:202-782-8396
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
DC488103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist