Provider Demographics
NPI:1184848558
Name:RATHIER, LUCILLE ANNE (PHD)
Entity Type:Individual
Prefix:DR
First Name:LUCILLE
Middle Name:ANNE
Last Name:RATHIER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:LUCILLE
Other - Middle Name:ANNE
Other - Last Name:CARDELLA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:1020 LAKE SUMTER LNDG
Mailing Address - Street 2:
Mailing Address - City:THE VILLAGES
Mailing Address - State:FL
Mailing Address - Zip Code:32162-2699
Mailing Address - Country:US
Mailing Address - Phone:352-674-8819
Mailing Address - Fax:352-674-8919
Practice Address - Street 1:280 FARNER PL
Practice Address - Street 2:
Practice Address - City:THE VILLAGES
Practice Address - State:FL
Practice Address - Zip Code:32163-6066
Practice Address - Country:US
Practice Address - Phone:352-674-1710
Practice Address - Fax:352-674-8990
Is Sole Proprietor?:No
Enumeration Date:2007-04-13
Last Update Date:2019-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPS00821103TH0004X
FLPY10047103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealth
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI33371-7OtherBCBS RI
RI414705OtherBLUECHIP
RI33371-7OtherBCBS RI