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General NPI Number Information
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NPI Number | 1023261104
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Entity Type | Organization
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Legal Business Name | DAVID L. THAYER, PSY.D.,P.C.
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Dates
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Enumeration Date | 11/03/2008
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Last Update Date | 11/03/2008
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Provider Practice Location Address
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Address Line | 821 W SOUTH ST SUITE D
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City | KALAMAZOO
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State | MI
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Zip | 49007-4684
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Country | US
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Telephone | 269-501-3493
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Fax | 269-344-5973
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Provider Business Mailing Address
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Address Line | 821 W SOUTH ST SUITE D
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City | KALAMAZOO
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State | MI
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Zip | 49007-4684
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Country | US
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Telephone | 269-501-3493
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Fax | 269-344-5973
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Authorized Official
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Title or Position | PRESIDENT
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Name | DAVID L THAYER
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Credential | PSY.D.,P.C.
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Telephone | 269-501-3493
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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