Provider Demographics
NPI:1891291654
Name:HARFORD, SHENTELL
Entity Type:Individual
Prefix:
First Name:SHENTELL
Middle Name:
Last Name:HARFORD
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 1:350 LENOX RD APT 2K
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11226-2283
Mailing Address - Country:US
Mailing Address - Phone:212-810-7146
Mailing Address - Fax:
Practice Address - Street 1:350 LENOX RD APT 2K
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11226-2283
Practice Address - Country:US
Practice Address - Phone:212-810-7146
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-02
Last Update Date:2018-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst