Provider Demographics
NPI:1326680471
Name:LOCKLEY, HARRIETTE
Entity Type:Individual
Prefix:
First Name:HARRIETTE
Middle Name:
Last Name:LOCKLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:306 CAVANAH DR
Mailing Address - Street 2:
Mailing Address - City:HOLLY HILL
Mailing Address - State:FL
Mailing Address - Zip Code:32117-4235
Mailing Address - Country:US
Mailing Address - Phone:386-307-4657
Mailing Address - Fax:
Practice Address - Street 1:306 CAVANAH DR
Practice Address - Street 2:
Practice Address - City:HOLLY HILL
Practice Address - State:FL
Practice Address - Zip Code:32117-4235
Practice Address - Country:US
Practice Address - Phone:386-307-4657
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-10
Last Update Date:2019-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care