Provider Demographics
NPI:1902417934
Name:KLEMOLA, HARLEY (MS BCBA)
Entity Type:Individual
Prefix:
First Name:HARLEY
Middle Name:
Last Name:KLEMOLA
Suffix:
Gender:F
Credentials:MS BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:491 KILVERT ST
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-1370
Mailing Address - Country:US
Mailing Address - Phone:401-618-6991
Mailing Address - Fax:
Practice Address - Street 1:491 KILVERT ST
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-1370
Practice Address - Country:US
Practice Address - Phone:401-618-6991
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-13
Last Update Date:2023-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst