Organization
DERYCK D. RICHARDSON, PH.D. LLC
Active
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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