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General NPI Number Information
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NPI Number | 1679963938
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Entity Type | Individual
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Provider Name | LOUIS L. ORR IV PSYD
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Gender | Male
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Dates
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Enumeration Date | 01/26/2015
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Last Update Date | 01/26/2015
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Provider Practice Location Address
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Address Line | 2804 W MARC KNIGHTON CT SUITE A
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City | LECANTO
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State | FL
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Zip | 34461-8334
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Country | US
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Telephone | 352-746-8067
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Fax | 352-746-8069
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Provider Business Mailing Address
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Address Line | 2804 W MARC KNIGHTON CT SUITE A
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City | LECANTO
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State | FL
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Zip | 34461-8334
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Country | US
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Telephone | 352-746-8067
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Fax | 352-746-8069
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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 9217
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License Number State | FL
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