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General NPI Number Information
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NPI Number | 1841553393
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Entity Type | Individual
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Provider Name | NICHOLAS RYAN GEHLE PSY.D.
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Gender | Male
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Dates
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Enumeration Date | 06/20/2012
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Last Update Date | 05/18/2015
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Provider Practice Location Address
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Address Line | 3632 LAND O LAKES BLVD SUITE 106 RM. 17
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City | LAND O LAKES
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State | FL
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Zip | 34639-4405
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Country | US
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Telephone | 813-513-9228
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Fax |
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Provider Business Mailing Address
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Address Line | 5537 SWEET WILLIAM TER
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City | LAND O LAKES
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State | FL
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Zip | 34639-2851
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Country | US
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Telephone | 937-477-4885
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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 | PY 8489
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License Number State | FL
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