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NPI Code Detail

MEDICARE: DR. DEAN RUSSELL CAULEY PH.D.

MEDICARE:  DR. DEAN RUSSELL CAULEY  PH.D.
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
1101YM0800XMental Health CounselorMH7104FL

General Provider Information

NPI Number : 1487858437
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DEAN RUSSELL CAULEY PH.D.
Provider Business Mailing Address
First Line : 3270 YUKON DR
Second Line :
City : PORT CHARLOTTE
State : FL
Zip : 33948-6130
Country : US
Telephone Number : 941-627-2867
Fax Number :
Provider Business Practice Location Address
First Line : 2765 TAMIAMI TRL STE C
Second Line :
City : PORT CHARLOTTE
State : FL
Zip : 33952-5163
Country : US
Telephone Number : 941-661-8895
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/13/2007
Last Update Date : 07/08/2007

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Directions to “ DR. DEAN RUSSELL CAULEY PH.D.” Practice Location

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