Provider Demographics
NPI:1477884484
Name:HARVEY, ADA CELESTE
Entity Type:Individual
Prefix:PROF
First Name:ADA
Middle Name:CELESTE
Last Name:HARVEY
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 1:2503 REFLECTIONS PL
Mailing Address - Street 2:
Mailing Address - City:WEST MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32904-6672
Mailing Address - Country:US
Mailing Address - Phone:321-674-8104
Mailing Address - Fax:
Practice Address - Street 1:150 W. UNIVERSITY BLVD
Practice Address - Street 2:FLORIDA INSTITUTE OF TECHNOLOGY
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32901-6975
Practice Address - Country:US
Practice Address - Phone:321-674-8104
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-15
Last Update Date:2010-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst