Dalton, Charles Brady

Dalton, Charles Brady is an sole proprietor health care provider with primary practice located at 3118 E Maryland Ave , Phoenix AZ 85016-2377. He recently has 4 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Adult Development & Aging, Behavioral Health & Social Service Providers / Psychologist. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Dalton, Charles Brady can be contacted via phone (602) 909-7539.

Contact Information

Primary practice address
3118 E Maryland Ave Phoenix AZ 85016-2377
Phone: (602) 909-7539
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 3660 Arizona
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 103TA0400X 3660 Arizona
Behavioral Health & Social Service Providers / Adult Development & Aging 103TA0700X 3660 Arizona
Behavioral Health & Social Service Providers / Psychologist 103T00000X 3660 Arizona

Profile Details

NPI number 1073782884
LBN Legal business name Dalton, Charles Brady
Credentials PSY.D
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 26th, 2008
Last updated Apr 29th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1073782884 NPPES
Arizona MEDICAID 1073782884

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