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General NPI Number Information
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NPI Number | 1427871755
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Entity Type | Individual
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Provider Name | HARLEY JAY CANTOR M.A, MFTC, RMFTI
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Gender | Male
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Dates
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Enumeration Date | 11/05/2024
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Last Update Date | 11/05/2024
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Provider Practice Location Address
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Address Line | 9939 HAWTHORNE ST
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City | HIGHLANDS RANCH
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State | CO
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Zip | 80126-7808
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Country | US
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Telephone | 786-553-8216
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Fax |
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Provider Business Mailing Address
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Address Line | 9939 HAWTHORNE ST
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City | HIGHLANDS RANCH
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State | CO
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Zip | 80126-7808
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Country | US
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Telephone | 786-553-8216
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TF0000X
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Taxonomy Name | Family Psychologist
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License Number | IMT4243
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License Number State | FL
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