Provider Demographics
NPI:1407819618
Name:VINCENT, RICHARD M (MSW)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:M
Last Name:VINCENT
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CMR 467 BOX 851
Mailing Address - Street 2:
Mailing Address - City:APO AE
Mailing Address - State:HESSEN
Mailing Address - Zip Code:09096
Mailing Address - Country:DE
Mailing Address - Phone:01490611-705-5999
Mailing Address - Fax:01490611-705-5984
Practice Address - Street 1:WIESBADEN HEALTH CLINIC
Practice Address - Street 2:
Practice Address - City:APO AE
Practice Address - State:HESSEN
Practice Address - Zip Code:09096
Practice Address - Country:DE
Practice Address - Phone:01490611-705-5999
Practice Address - Fax:01490611-705-5984
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVDP008167771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical