MEDICARE: JUSTYN HARVEY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst	1-16-24300	FL

General Provider Information

NPI Number	:	1194133447
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUSTYN HARVEY

Provider Business Mailing Address
First Line	:	66 MILL CREEK DR
Second Line	:
City	:	YOUNGSTOWN
State	:	OH
Zip	:	44512-1549
Country	:	US
Telephone Number	:	561-279-3852
Fax Number	:	561-437-8116

Provider Business Practice Location Address
First Line	:	66 MILL CREEK DR
Second Line	:
City	:	YOUNGSTOWN
State	:	OH
Zip	:	44512-1549
Country	:	US
Telephone Number	:	561-279-3852
Fax Number	:	561-437-8116

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/31/2014
Last Update Date	:	10/18/2024

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Directions to “ JUSTYN HARVEY ” Practice Location

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