Provider Demographics
NPI:1346965787
Name:ADAMS, DAVID TIMOTHY
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:TIMOTHY
Last Name:ADAMS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3650 N CAMPBELL RD
Mailing Address - Street 2:
Mailing Address - City:PALMER
Mailing Address - State:AK
Mailing Address - Zip Code:99645-5729
Mailing Address - Country:US
Mailing Address - Phone:907-738-6021
Mailing Address - Fax:
Practice Address - Street 1:3650 N CAMPBELL RD
Practice Address - Street 2:
Practice Address - City:PALMER
Practice Address - State:AK
Practice Address - Zip Code:99645-5729
Practice Address - Country:US
Practice Address - Phone:907-738-6021
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-07
Last Update Date:2022-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor