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Individual

CHRISTOPHER THOMAS RACKLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PSYD

Contact information

Practice address
13241 BARTRAM PARK BLVD UNIT 1901, JACKSONVILLE, FL 32258-5228
(904) 376-3800
(904) 396-8967
Mailing address
PO BOX 748519, ATLANTA, GA 30374-8519
(904) 376-3800
(904) 376-3998

Taxonomy

Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
PY10506
FL
103TC0700X
Clinical Psychologist
PY10506
FL
103TC2200X
Clinical Child & Adolescent Psychologist
017020
NY

Other

Enumeration date
04/13/2007
Last updated
08/05/2022
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