Provider Demographics
NPI:1497330161
Name:SPEECHLY, DAVID PAUL (PHD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:PAUL
Last Name:SPEECHLY
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 1:1085 YORKSHIRE PL
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94506-1270
Mailing Address - Country:US
Mailing Address - Phone:925-389-3622
Mailing Address - Fax:
Practice Address - Street 1:4125 BLACKHAWK PLAZA CIR STE 166
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:CA
Practice Address - Zip Code:94506-4673
Practice Address - Country:US
Practice Address - Phone:925-389-3622
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-15
Last Update Date:2021-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty