Doctor Name: | DR. MICHAEL H RATHJENS |
NPI Number: | 1073612404 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PSY.D. |
License Number: | PY4666 |
Business Practice Address: | 12012 South Shore Blvd. Suite 108 Wellington, FL - 33414 |
Business Phone Number: | 5617907975 |
Business Fax Number: | 5617904788 |
Mailing Address: | 4682 Foxview Place, LAKE WORTH |
State: | FL |
Postal Code: | 334673510 |
Phone Number: | 5617907975 |
Fax Number: | 5617904788 |
NPI Enumeration Date: | 09/22/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | PY4666 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |