Provider Demographics
NPI:1679568737
Name:MCDOUGALL, BARBARA JEANNE II (PSYD)
Entity type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:JEANNE
Last Name:MCDOUGALL
Suffix:II
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2871 RAVINES RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURG
Mailing Address - State:FL
Mailing Address - Zip Code:32068-5729
Mailing Address - Country:US
Mailing Address - Phone:904-282-4242
Mailing Address - Fax:
Practice Address - Street 1:6545 BOWDEN RD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-6149
Practice Address - Country:US
Practice Address - Phone:904-448-0079
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-15
Last Update Date:2012-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY7136103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL75044Medicare ID - Type Unspecified