Provider Demographics
NPI:1700265360
Name:HARVEY, CANDI
Entity Type:Individual
Prefix:
First Name:CANDI
Middle Name:
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 1:8 LONG MEADOW PL
Mailing Address - Street 2:
Mailing Address - City:ROTONDA WEST
Mailing Address - State:FL
Mailing Address - Zip Code:33947-1806
Mailing Address - Country:US
Mailing Address - Phone:941-223-7449
Mailing Address - Fax:
Practice Address - Street 1:8 LONG MEADOW PL
Practice Address - Street 2:
Practice Address - City:ROTONDA WEST
Practice Address - State:FL
Practice Address - Zip Code:33947-1806
Practice Address - Country:US
Practice Address - Phone:941-223-7449
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-28
Last Update Date:2015-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst