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General NPI Number Information
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NPI Number | 1134912595
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Entity Type | Individual
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Provider Name | DAVID EVERETT DILLARD LMFT
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Gender | Male
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Dates
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Enumeration Date | 05/27/2025
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Last Update Date | 05/27/2025
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Provider Practice Location Address
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Address Line | 1313 LYNDON LN STE 211
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City | LOUISVILLE
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State | KY
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Zip | 40222-7302
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Country | US
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Telephone | 502-303-5720
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Fax |
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Provider Business Mailing Address
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Address Line | 117 N GALT AVE
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City | LOUISVILLE
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State | KY
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Zip | 40206-2309
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Country | US
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Telephone | 502-593-2205
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Fax | 502-593-2205
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 163177
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License Number State | KY
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