Provider Demographics
NPI:1528225612
Name:RARICK, SUSAN LOUISE (PHD)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:LOUISE
Last Name:RARICK
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 1:20747 STERLINGTON DRIVE
Mailing Address - Street 2:
Mailing Address - City:LAND O LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:34638
Mailing Address - Country:US
Mailing Address - Phone:813-943-4000
Mailing Address - Fax:813-948-0094
Practice Address - Street 1:20747 STERLINGTON DRIVE
Practice Address - Street 2:
Practice Address - City:LAND O LAKES
Practice Address - State:FL
Practice Address - Zip Code:34638
Practice Address - Country:US
Practice Address - Phone:813-943-4000
Practice Address - Fax:813-948-0094
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-17
Last Update Date:2019-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY 8078103T00000X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist