Individual
BLAKE ROBERT HARRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
11010 DOMAIN DR, APT 11331, AUSTIN, TX 78758-7711
(214) 837-7999
Mailing address
11010 DOMAIN DR, APT 11331, AUSTIN, TX 78758-7711
(214) 837-7999
Taxonomy
Speciality
Code
Description
License number
State
103TF0200X
Forensic Psychologist
Primary
36688
TX
Other
Enumeration date
04/16/2014
Last updated
04/16/2014
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