Individual
DR. RICARDO DWAYNE LAGRANGE
Active
Individual
DR. RICARDO DWAYNE LAGRANGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
04481
MD
103TC0700X
Clinical Psychologist
Primary
PSY1000543
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036596300
—
MD
05
—
417682100
—
MD
05
—
417682101
—
MD
Enumeration date
06/10/2009
Last updated
04/10/2012
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