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General NPI Number Information
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NPI Number | 1295725034
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Entity Type | Individual
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Provider Name | RICHARD E NAY PHD
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Gender | Male
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Dates
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Enumeration Date | 10/24/2005
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Last Update Date | 11/05/2013
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Provider Practice Location Address
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Address Line | 2970 HARTLEY RD STE 201
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City | JACKSONVILLE
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State | FL
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Zip | 32257-8227
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Country | US
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Telephone | 904-886-4998
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Fax | 904-292-1094
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Provider Business Mailing Address
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Address Line | PO BOX 23040
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City | JACKSONVILLE
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State | FL
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Zip | 32241-3040
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Country | US
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Telephone | 904-886-4998
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Fax | 904-292-1094
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PY0004562
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License Number State | FL
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