Provider Demographics
NPI:1295201283
Name:DALE, MEGAN AMBER (PSYD)
Entity type:Individual
Prefix:DR
First Name:MEGAN
Middle Name:AMBER
Last Name:DALE
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:AMBER
Other - Last Name:DAVIDSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:294 W PATRICK ST
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85233-8762
Mailing Address - Country:US
Mailing Address - Phone:623-271-4456
Mailing Address - Fax:
Practice Address - Street 1:1810 E RAY RD STE A104
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85225-8720
Practice Address - Country:US
Practice Address - Phone:480-428-3996
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-17
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ005011103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist