Provider Demographics
NPI:1841540655
Name:CANTER, DAVID EDWARD (PHD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:EDWARD
Last Name:CANTER
Suffix:
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 1:8214 COOPER ST
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22309-1052
Mailing Address - Country:US
Mailing Address - Phone:703-799-5851
Mailing Address - Fax:
Practice Address - Street 1:2300 N PERSHING DR
Practice Address - Street 2:SUITE 201
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22201-1428
Practice Address - Country:US
Practice Address - Phone:703-772-8677
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-19
Last Update Date:2012-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810004399103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical