Provider Demographics
NPI:1477641355
Name:SEDLACEK, DAVID ALLEN (PHD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:ALLEN
Last Name:SEDLACEK
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 1:302 BOB G HUGHES BLVD
Mailing Address - Street 2:
Mailing Address - City:HARVEST
Mailing Address - State:AL
Mailing Address - Zip Code:35749-4861
Mailing Address - Country:US
Mailing Address - Phone:256-830-5448
Mailing Address - Fax:
Practice Address - Street 1:7000 ADVENTIST BLVD NW
Practice Address - Street 2:GREEN HALL ROOM 205
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35896-0001
Practice Address - Country:US
Practice Address - Phone:256-726-7607
Practice Address - Fax:256-726-7527
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1870C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical