Doctor Name: | DR. STEPHEN ANTHONY RAGUSEA |
NPI Number: | 1043300361 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PSY.D. |
License Number: | PS004089L |
Business Practice Address: | 1901 Fogarty Ave Suite #5 Key West, FL - 330403614 |
Business Phone Number: | 3052942500 |
Business Fax Number: | |
Mailing Address: | 1901 Fogarty Ave, Suite #5 KEY WEST |
State: | FL |
Postal Code: | 330403614 |
Phone Number: | 3052942500 |
Fax Number: | |
NPI Enumeration Date: | 10/15/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | PS004089L |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | PA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |