Provider Demographics
NPI:1316116908
Name:HARLAN, WANDA J
Entity type:Individual
Prefix:MRS
First Name:WANDA
Middle Name:J
Last Name:HARLAN
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 1:1170 W OLIVE AVE
Mailing Address - Street 2:SUITE G
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95348-1959
Mailing Address - Country:US
Mailing Address - Phone:209-725-2125
Mailing Address - Fax:209-384-1495
Practice Address - Street 1:1170 W OLIVE AVE
Practice Address - Street 2:SUITE G
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95348-1959
Practice Address - Country:US
Practice Address - Phone:209-725-2125
Practice Address - Fax:209-384-1495
Is Sole Proprietor?:No
Enumeration Date:2008-02-27
Last Update Date:2008-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health