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General NPI Number Information
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NPI Number | 1528225612
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Entity Type | Individual
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Provider Name | SUSAN LOUISE RARICK PH.D.
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Gender | Female
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Dates
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Enumeration Date | 05/17/2008
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Last Update Date | 03/11/2019
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Provider Practice Location Address
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Address Line | 20747 STERLINGTON DRIVE
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City | LAND O LAKES
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State | FL
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Zip | 34638
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Country | US
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Telephone | 813-943-4000
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Fax | 813-948-0094
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Provider Business Mailing Address
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Address Line | 20747 STERLINGTON DRIVE
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City | LAND O LAKES
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State | FL
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Zip | 34638
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Country | US
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Telephone | 813-943-4000
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Fax | 813-948-0094
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PY 8078
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License Number State | FL
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