Healthcare Provider Details

I. General information

NPI: 1184848558
Provider Name (Legal Business Name): LUCILLE ANNE RATHIER PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LUCILLE ANNE CARDELLA PH.D.

II. Dates (important events)

Enumeration Date: 04/13/2007
Last Update Date: 01/03/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

280 FARNER PL
THE VILLAGES FL
32163-6066
US

IV. Provider business mailing address

1020 LAKE SUMTER LNDG
THE VILLAGES FL
32162-2699
US

V. Phone/Fax

Practice location:
  • Phone: 352-674-1710
  • Fax: 352-674-8990
Mailing address:
  • Phone: 352-674-8819
  • Fax: 352-674-8919

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TH0004X
TaxonomyHealth Psychologist
License NumberPS00821
License Number StateRI
# 2
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPY10047
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: