Provider Demographics
NPI:1497033476
Name:FATTER, DAPHNE (PHD)
Entity Type:Individual
Prefix:
First Name:DAPHNE
Middle Name:
Last Name:FATTER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:DAPHNE
Other - Middle Name:
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:PO BOX 866222
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75086-6222
Mailing Address - Country:US
Mailing Address - Phone:469-320-9668
Mailing Address - Fax:
Practice Address - Street 1:6675 MEDITERRANEAN DR
Practice Address - Street 2:SUITE 305
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-5573
Practice Address - Country:US
Practice Address - Phone:469-320-9668
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-25
Last Update Date:2015-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX36337103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling