| Doctor Name: | MR. WAYNE DOUGLAS MEDDOCK |
| NPI Number: | 1033126875 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LMHC |
| License Number: | MH2606 |
| Business Practice Address: | 601 W Alverdez Ave Clewiston, FL - 334403504 |
| Business Phone Number: | 8636744050 |
| Business Fax Number: | 8636744052 |
| Mailing Address: | 413 Sw 45th St, CAPE CORAL |
| State: | FL |
| Postal Code: | 339147531 |
| Phone Number: | 2399451952 |
| Fax Number: | |
| NPI Enumeration Date: | 08/02/2006 |
| NPI Last Update Date: | 04/21/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | MH2606 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | FL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |