Provider Demographics
NPI:1982025417
Name:HARVEY, RALPH III
Entity Type:Individual
Prefix:MR
First Name:RALPH
Middle Name:
Last Name:HARVEY
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2771 HYPOLUXO RD
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33462-3826
Mailing Address - Country:US
Mailing Address - Phone:561-843-4877
Mailing Address - Fax:561-413-2510
Practice Address - Street 1:2240 W WOOLBRIGHT RD STE 322
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33426-6364
Practice Address - Country:US
Practice Address - Phone:561-843-4877
Practice Address - Fax:561-413-2510
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-31
Last Update Date:2013-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL10D2068987103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst