Doctor Name: | DAVID J WARSHAUER |
NPI Number: | 1336255736 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PHD |
License Number: | |
Business Practice Address: | 204 South Street Anna, IL - 629060548 |
Business Phone Number: | 6188338551 |
Business Fax Number: | 6188332911 |
Mailing Address: | Po Box 548, ANNA |
State: | IL |
Postal Code: | 629060548 |
Phone Number: | 6188338551 |
Fax Number: | 6188332911 |
NPI Enumeration Date: | 08/21/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |