Healthcare Provider Details

I. General information

NPI: 1447490164
Provider Name (Legal Business Name): RICHARD H. MCLAUGHLIN PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/21/2009
Last Update Date: 02/21/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5201 RAYMOND ST
ORLANDO FL
32803-8208
US

IV. Provider business mailing address

2319 TREYMORE DR
ORLANDO FL
32825-7540
US

V. Phone/Fax

Practice location:
  • Phone: 407-629-1599
  • Fax:
Mailing address:
  • Phone: 407-625-3881
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License NumberPY6171
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: