Provider Demographics
NPI:1558493361
Name:MCDOUGALL, ALFRED GRANT (PHD)
Entity Type:Individual
Prefix:DR
First Name:ALFRED
Middle Name:GRANT
Last Name:MCDOUGALL
Suffix:
Gender:M
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:PO BOX 357504
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32635-7504
Mailing Address - Country:US
Mailing Address - Phone:352-375-4440
Mailing Address - Fax:352-378-1828
Practice Address - Street 1:5024 NW 27TH COURT
Practice Address - Street 2:COURT B
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32606
Practice Address - Country:US
Practice Address - Phone:352-378-2600
Practice Address - Fax:352-378-1828
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-09
Last Update Date:2016-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH5756101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health