Provider Demographics
NPI:1871347765
Name:HARKNESS, CHRIS
Entity type:Individual
Prefix:
First Name:CHRIS
Middle Name:
Last Name:HARKNESS
Suffix:
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 1:179 OTTERBEIN DR
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44904-9776
Mailing Address - Country:US
Mailing Address - Phone:567-224-0708
Mailing Address - Fax:
Practice Address - Street 1:179 OTTERBEIN DR
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44904-9776
Practice Address - Country:US
Practice Address - Phone:567-224-0708
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-16
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health