Provider Demographics
NPI:1801935945
Name:BRADY, DON PAUL (PHD, PSYD)
Entity type:Individual
Prefix:DR
First Name:DON
Middle Name:PAUL
Last Name:BRADY
Suffix:
Gender:M
Credentials:PHD, PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6230 DYKE RD
Mailing Address - Street 2:
Mailing Address - City:CHITTENANGO
Mailing Address - State:NY
Mailing Address - Zip Code:13037-9404
Mailing Address - Country:US
Mailing Address - Phone:315-687-6993
Mailing Address - Fax:315-687-6993
Practice Address - Street 1:6230 DYKE RD
Practice Address - Street 2:
Practice Address - City:CHITTENANGO
Practice Address - State:NY
Practice Address - Zip Code:13037-9404
Practice Address - Country:US
Practice Address - Phone:315-687-6993
Practice Address - Fax:315-687-6993
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000605-1106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist