Provider Demographics
NPI:1346562295
Name:T RICHARD SAUNDERS PL
Entity type:Organization
Organization Name:T RICHARD SAUNDERS PL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:SAUNDERS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:443-534-3208
Mailing Address - Street 1:136 JULIA ST UNIT 100
Mailing Address - Street 2:
Mailing Address - City:NEW SMYRNA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32168-7713
Mailing Address - Country:US
Mailing Address - Phone:386-423-9161
Mailing Address - Fax:386-423-3094
Practice Address - Street 1:136 JULIA ST UNIT 100
Practice Address - Street 2:
Practice Address - City:NEW SMYRNA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32168-7713
Practice Address - Country:US
Practice Address - Phone:386-423-9161
Practice Address - Fax:386-423-3094
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-19
Last Update Date:2020-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DA667AMedicare PIN