Doctor Name: | MR. RICHARD WARD CANTRELL |
NPI Number: | 1023193265 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MS |
License Number: | LH00005222 |
Business Practice Address: | 1175 Carondelet Dr Richland, WA - 993543300 |
Business Phone Number: | 5099439104 |
Business Fax Number: | 5099467206 |
Mailing Address: | 1175 Carondelet Dr, RICHLAND |
State: | WA |
Postal Code: | 993543300 |
Phone Number: | 5099439104 |
Fax Number: | 5099467206 |
NPI Enumeration Date: | 10/26/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | LH00005222 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |