DAVID L WODRICH PH.D.
Clinical Neuropsychologist
Phoenix, Arizona
Provider NPI: 1629037429
Provider Information:DAVID L WODRICH PH.D.
Gender: M
Not Sole Proprietor
Practice Location:
1919 E THOMAS RD BLDG B PHOENIX, AZ 85016 US
Tel: 602-546-0486 Fax: 602-546-1631
Business Mailing Address:
1919 E THOMAS RD BLDG C MANAGED CARE PHOENIX, AZ 85016 US
Tel: 602-546-0486 Fax: 602-546-1631
Entity Type: Individual
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
Y | 103G00000X | Behavioral Health & Social Service Providers Clinical Neuropsychologist | AZ | 445 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
730714 | AZ | 05 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin