Provider Demographics
NPI:1427023167
Name:HARLEY, REBECCA MARIE (PHD)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:MARIE
Last Name:HARLEY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:294 WASHINGTON ST
Mailing Address - Street 2:SUITE 313
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02108-4634
Mailing Address - Country:US
Mailing Address - Phone:617-724-6300
Mailing Address - Fax:
Practice Address - Street 1:294 WASHINGTON ST
Practice Address - Street 2:SUITE 313
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02108-4634
Practice Address - Country:US
Practice Address - Phone:617-724-6300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA79782084P0800X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0501930Medicaid
MAW06140OtherBCBS MA
MAW06140OtherBCBS MA