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General NPI Number Information
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NPI Number | 1902251002
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Entity Type | Individual
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Provider Name | MICHAEL DAVID MCGADY JR. PSY. D.
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Gender | Male
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Dates
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Enumeration Date | 04/27/2016
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Last Update Date | 02/27/2020
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Provider Practice Location Address
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Address Line | 4425 W OLIVE AVE STE 151A
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City | GLENDALE
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State | AZ
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Zip | 85302-3843
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Country | US
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Telephone | 602-456-4817
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Fax | 480-247-4318
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Provider Business Mailing Address
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Address Line | 2428 E APACHE BLVD
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City | TEMPE
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State | AZ
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Zip | 85281-4935
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Country | US
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Telephone | 602-402-0971
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Fax |
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 4728
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License Number State | AZ
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