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General NPI Number Information
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NPI Number | 1700839594
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Entity Type | Individual
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Provider Name | RICHARD D. MCANULTY PH.D.
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Gender | Male
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Dates
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Enumeration Date | 05/19/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 6201 FAIRVIEW RD SUITE 200
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City | CHARLOTTE
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State | NC
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Zip | 28210-3289
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Country | US
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Telephone | 704-687-4783
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Fax |
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Provider Business Mailing Address
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Address Line | 8505 LOCKERBIE LN
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City | CHARLOTTE
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State | NC
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Zip | 28215-7321
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Country | US
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Telephone | 704-609-6215
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Fax |
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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 | 1766
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License Number State | NC
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