Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TB0200X | Cognitive & Behavioral Psychologist | IL | |
N | 103TB0200X | Cognitive & Behavioral Psychologist | 4267 | OH |
N | 103TB0200X | Cognitive & Behavioral Psychologist | PS-005374-L | PA |
N | 103G00000X | Clinical Psychologist | IL | |
N | 103TC0700X | Clinical Psychologist | IL | |
Y | 103G00000X | Clinical Psychologist | 4267 | OH |
Y | 103TC0700X | Clinical Psychologist | 4267 | OH |
N | 103G00000X | Clinical Psychologist | PS-005374-L | PA |
N | 103TC0700X | Clinical Psychologist | PS-005374-L | PA |
NPI | 1184747560 |
---|---|
Provider Name | Dr. David J Greenwald |
First Address | Fairfield, OH 45014-2222 |
Second Address | Fairfield, OH 45014-2222 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/04/2007 |
Last Update Date | 29/01/2008 |