Individual
DR. RICARDO DWAYNE LAGRANGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
111 MICHIGAN AVE NW, 6TH FLOOR - RESEARCH, WASHINGTON, DC 20010-2916
(202) 476-4455
(202) 476-3425
Mailing address
7610 PENNSYLVANIA AVE, #203, FORESTVILLE, MD 20747-4701
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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