Doctor Name: | DAVID MICHAEL PHELAN |
NPI Number: | 1043240666 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.C. |
License Number: | LPC-2307 |
Business Practice Address: | 501 E Plaza Cir Dr Suite A Litchfield Park, AZ - 853404998 |
Business Phone Number: | 6235367956 |
Business Fax Number: | |
Mailing Address: | 501 E Plaza Cir Dr, Suite A LITCHFIELD PARK |
State: | AZ |
Postal Code: | 853404998 |
Phone Number: | 6235367956 |
Fax Number: | |
NPI Enumeration Date: | 07/03/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | LPC-2307 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AZ |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |