Provider Demographics
NPI:1811077647
Name:DE BLAEY, DAVID JOHN (MA)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:JOHN
Last Name:DE BLAEY
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
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Mailing Address - Street 1:6390 E THOMAS RD
Mailing Address - Street 2:#120
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251
Mailing Address - Country:US
Mailing Address - Phone:480-945-1884
Mailing Address - Fax:480-945-6591
Practice Address - Street 1:6390 E THOMAS RD
Practice Address - Street 2:#120
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251
Practice Address - Country:US
Practice Address - Phone:480-945-1884
Practice Address - Fax:480-945-6591
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ#0505101YP2500X
AZ#0169106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist