Provider Demographics
NPI:1992724801
Name:SMALL, RICHARD F (PHD)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:F
Last Name:SMALL
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 1:2909 WINDMILL RD
Mailing Address - Street 2:
Mailing Address - City:SINKING SPRING
Mailing Address - State:PA
Mailing Address - Zip Code:19608-1681
Mailing Address - Country:US
Mailing Address - Phone:610-678-3730
Mailing Address - Fax:610-678-7853
Practice Address - Street 1:2909 WINDMILL RD
Practice Address - Street 2:
Practice Address - City:SINKING SPRING
Practice Address - State:PA
Practice Address - Zip Code:19608-1681
Practice Address - Country:US
Practice Address - Phone:610-678-3730
Practice Address - Fax:610-678-7853
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS002912L103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical