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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:

PrimaryCodeCategory/DescriptionStateLicense Number
Y103G00000XBehavioral Health & Social Service Providers
Clinical Neuropsychologist
AZ445

Other Provider Identifiers:

IssuerNumberStateType
108314AZ04
730714AZ05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







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