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General NPI Number Information
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NPI Number | 1588996458
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Entity Type | Organization
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Legal Business Name | DAVID G DAVIDSON-METHOT, PHD, PLLC
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Dates
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Enumeration Date | 02/03/2010
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Last Update Date | 02/03/2010
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Provider Practice Location Address
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Address Line | 33 N LINDSAY RD SUITE 106
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City | GILBERT
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State | AZ
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Zip | 85234-5807
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Country | US
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Telephone | 480-262-0326
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Fax | 480-813-2706
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Provider Business Mailing Address
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Address Line | 70 S VAL VISTA DR SUITE A3, #477
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City | GILBERT
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State | AZ
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Zip | 85296-1374
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Country | US
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Telephone | 480-262-0326
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Fax | 480-813-2706
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Authorized Official
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Title or Position | SOLE PROPRIETOR/PLLC
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Name | DAVID G DAVIDSON-METHOT
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Credential | PHD
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Telephone | 480-262-0326
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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 | 3732
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License Number State | AZ
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