Provider Demographics
NPI:1336537380
Name:HARLEY, RODNEY (PHD, CAP)
Entity Type:Individual
Prefix:DR
First Name:RODNEY
Middle Name:
Last Name:HARLEY
Suffix:
Gender:M
Credentials:PHD, CAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6911
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33508-6015
Mailing Address - Country:US
Mailing Address - Phone:813-784-5617
Mailing Address - Fax:
Practice Address - Street 1:1463 OAKFIELD DR
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-3899
Practice Address - Country:US
Practice Address - Phone:813-784-5617
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-29
Last Update Date:2014-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3244101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional