Provider Demographics
NPI:1316269491
Name:MCKEE, RICHARD DAVID (PHD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:DAVID
Last Name:MCKEE
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 1:2328 COUNTY HWY E
Mailing Address - Street 2:
Mailing Address - City:WARRENS
Mailing Address - State:WI
Mailing Address - Zip Code:54666-8529
Mailing Address - Country:US
Mailing Address - Phone:608-378-4063
Mailing Address - Fax:
Practice Address - Street 1:2328 COUNTY HWY E
Practice Address - Street 2:
Practice Address - City:WARRENS
Practice Address - State:WI
Practice Address - Zip Code:54666-8529
Practice Address - Country:US
Practice Address - Phone:608-378-4063
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-17
Last Update Date:2010-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1902-57103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical