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General NPI Number Information
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NPI Number | 1487705315
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Entity Type | Organization
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Legal Business Name | CAROL A. RICHARDS PSYD.
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Dates
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Enumeration Date | 01/16/2007
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Last Update Date | 06/13/2008
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Provider Practice Location Address
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Address Line | 3970 MAIN ST. SUITE 4
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City | KELSEYVILLE
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State | CA
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Zip | 95451
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Country | US
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Telephone | 707-279-4607
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 974
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City | COBB
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State | CA
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Zip | 95426-0974
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CLINICIAN
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Name | CAROL A. RICHARDS
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Credential |
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Telephone | 707-263-0877
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251300000X
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Taxonomy Name | Local Education Agency (LEA)
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License Number |
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License Number State |
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