Provider Demographics
NPI:1053474478
Name:MCGAUGHRAN, VIRGINIA LEE (PHD)
Entity Type:Individual
Prefix:DR
First Name:VIRGINIA
Middle Name:LEE
Last Name:MCGAUGHRAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10538 LAKE VISTA CIRCLE
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33498
Mailing Address - Country:US
Mailing Address - Phone:561-451-8524
Mailing Address - Fax:561-477-8296
Practice Address - Street 1:22047 STATE RD 7
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33428
Practice Address - Country:US
Practice Address - Phone:561-451-8524
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY0004237103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL73640Medicare ID - Type Unspecified