Provider Demographics
NPI:1508267881
Name:TOP, DAVID NICHOLAS JR (PHD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:NICHOLAS
Last Name:TOP
Suffix:JR
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 1:308 S 1800 W
Mailing Address - Street 2:
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84601-3800
Mailing Address - Country:US
Mailing Address - Phone:385-499-9429
Mailing Address - Fax:801-373-0639
Practice Address - Street 1:308 S 1800 W
Practice Address - Street 2:
Practice Address - City:PROVO
Practice Address - State:UT
Practice Address - Zip Code:84601-3800
Practice Address - Country:US
Practice Address - Phone:385-499-9429
Practice Address - Fax:801-373-0639
Is Sole Proprietor?:No
Enumeration Date:2014-09-05
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041S0200X
UT11991237-2501103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool