Provider Demographics
NPI:1508253246
Name:DAVID, DARYN (PHD)
Entity Type:Individual
Prefix:DR
First Name:DARYN
Middle Name:
Last Name:DAVID
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:830 SHERMAN AVE
Mailing Address - Street 2:SUITE #1
Mailing Address - City:HAMDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06514-1147
Mailing Address - Country:US
Mailing Address - Phone:203-288-4325
Mailing Address - Fax:
Practice Address - Street 1:830 SHERMAN AVE
Practice Address - Street 2:SUITE #1
Practice Address - City:HAMDEN
Practice Address - State:CT
Practice Address - Zip Code:06514-1147
Practice Address - Country:US
Practice Address - Phone:203-288-4325
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-21
Last Update Date:2015-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT003133103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical