Individual
JOVON HARLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
13873 PARK CENTER RD STE 150L, HERNDON, VA 20171-3248
(703) 479-5259
Mailing address
13873 PARK CENTER RD STE 150L, HERNDON, VA 20171-3248
(703) 479-5259
Taxonomy
Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
—
—
174400000X
Specialist
—
—
251E00000X
Home Health Agency
—
—
305S00000X
Point of Service
Primary
—
—
3747A0650X
Attendant Care Provider
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
872269864
—
DE
Enumeration date
09/22/2022
Last updated
09/22/2022
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