Organization
DERYCK D. RICHARDSON, PH.D. LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DERYCK D'ARCY RICHARDSON PH.D. (PRESIDENT)
(614) 888-5255
Entity
Organization
Contact information
Practice address
1425 E DUBLIN GRANVILLE RD, SUITE 204, COLUMBUS, OH 43229-3325
(614) 888-5255
(614) 888-2306
Mailing address
1425 E DUBLIN GRANVILLE RD, SUITE 204, COLUMBUS, OH 43229-3325
(614) 888-5255
(614) 888-2306
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
2950
OH
261QM0855X
Adolescent and Children Mental Health Clinic/Center
2950
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0453389
—
OH
Enumeration date
02/01/2012
Last updated
02/01/2012
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