Provider Demographics
NPI:1497998751
Name:PILLAR, DAVID DELANO (MDIV)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:DELANO
Last Name:PILLAR
Suffix:
Gender:M
Credentials:MDIV
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39919 N JUSTICE WAY
Mailing Address - Street 2:
Mailing Address - City:ANTHEM
Mailing Address - State:AZ
Mailing Address - Zip Code:85086-1651
Mailing Address - Country:US
Mailing Address - Phone:602-692-0856
Mailing Address - Fax:
Practice Address - Street 1:18010 N TATUM BLVD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-1507
Practice Address - Country:US
Practice Address - Phone:602-692-0856
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-15
Last Update Date:2009-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4573101YP1600X
AZLMFT-0374106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral