Healthcare Provider Details

I. General information

NPI: 1497998751
Provider Name (Legal Business Name): DAVID DELANO PILLAR M.DIV.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/15/2009
Last Update Date: 04/15/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18010 N TATUM BLVD
PHOENIX AZ
85032-1507
US

IV. Provider business mailing address

39919 N JUSTICE WAY
ANTHEM AZ
85086-1651
US

V. Phone/Fax

Practice location:
  • Phone: 602-692-0856
  • Fax:
Mailing address:
  • Phone: 602-692-0856
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number4573
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT-0374
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: