Provider Demographics
NPI:1093024812
Name:GAFFNEY, CAROL RENAUD (PHD)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:RENAUD
Last Name:GAFFNEY
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 1:2240 ASHTON OAKS LN APT 103
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34109-1496
Mailing Address - Country:US
Mailing Address - Phone:401-345-8950
Mailing Address - Fax:
Practice Address - Street 1:2240 ASHTON OAKS LN APT 103
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34109
Practice Address - Country:US
Practice Address - Phone:401-345-8950
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-28
Last Update Date:2018-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPS01206103TC0700X
MA6492103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical