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Individual

DR. RICHARD ALBERT GAUDET

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PSYD

Contact information

Practice address
535 WALNUT LN, PHILADELPHIA, PA 19128-1742
(215) 298-4515
Mailing address
535 WALNUT LN, PHILADELPHIA, PA 19128-1742
(215) 298-4515

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSO 16156
PA
103T00000X
Psychologist
PY 00052525
FL
103TF0200X
Forensic Psychologist
35S100457500
NJ

Other

Enumeration date
11/20/2008
Last updated
11/20/2008
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