Provider Demographics
NPI:1417984147
Name:READY, DAVID J (PHD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:J
Last Name:READY
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1864 INDEPENDENCE SQ STE A
Mailing Address - Street 2:
Mailing Address - City:DUNWOODY
Mailing Address - State:GA
Mailing Address - Zip Code:30338-5160
Mailing Address - Country:US
Mailing Address - Phone:770-354-4272
Mailing Address - Fax:
Practice Address - Street 1:1864 INDEPENDENCE SQ STE A
Practice Address - Street 2:
Practice Address - City:DUNWOODY
Practice Address - State:GA
Practice Address - Zip Code:30338-5160
Practice Address - Country:US
Practice Address - Phone:770-354-4272
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2020-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAGA001847103TC0700X
GA001847103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical