Organization
FRED J. RAHAIM, PH.D. P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FRED JOSEPH RAHAIM PH.,D. (LICENSED PSYCHOLOGIST)
(904) 704-0851
Entity
Organization
Contact information
Practice address
5635 CREST CREEK DR, JACKSONVILLE, FL 32258-5358
(904) 704-0851
(904) 880-0652
Mailing address
5635 CREST CREEK DR, JACKSONVILLE, FL 32258-5358
(904) 704-0851
(904) 880-0652
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY00002524
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1265475412
NPI
—
Enumeration date
09/24/2013
Last updated
09/24/2013
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