Provider Demographics
NPI:1447707435
Name:HARLEY, VICTORIA (PSYD)
Entity type:Individual
Prefix:DR
First Name:VICTORIA
Middle Name:
Last Name:HARLEY
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1824 CALIFORNIA ST NW
Mailing Address - Street 2:APT. 2
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20009-1895
Mailing Address - Country:US
Mailing Address - Phone:203-561-5937
Mailing Address - Fax:
Practice Address - Street 1:4601 CONNECTICUT AVE NW
Practice Address - Street 2:SUITE 20
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20008-5700
Practice Address - Country:US
Practice Address - Phone:202-854-8369
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-07
Last Update Date:2016-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPSYA00076103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical