| Doctor Name: | DAVID J MACINTYRE |
| NPI Number: | 1043402092 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PSY.D. |
| License Number: | 180.003018 |
| Business Practice Address: | 2405 Schofield Ave Suite 210 Weston, WI - 544762300 |
| Business Phone Number: | 7152982846 |
| Business Fax Number: | 7152983146 |
| Mailing Address: | 2405 Schofield Ave, Suite 210 WESTON |
| State: | WI |
| Postal Code: | 544762300 |
| Phone Number: | 7152982846 |
| Fax Number: | 7152983146 |
| NPI Enumeration Date: | 08/14/2007 |
| NPI Last Update Date: | 03/03/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 180.003018 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |