Individual
DR. DAVID RAQUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D
Contact information
Practice address
11B LENOX POINTE NE, ATLANTA, GA 30324-3171
(706) 455-2492
(706) 492-5714
Mailing address
PO BOX 429, MINERAL BLUFF, GA 30559-0429
(706) 455-2492
(704) 492-5714
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY000413
GA
103TC0700X
Clinical Psychologist
PSY000413
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PSY000413
LICENSE NUMBER
GA
Enumeration date
12/08/2006
Last updated
09/11/2025
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