Provider Demographics
NPI:1962433425
Name:FERO, DAVID DALE (PHD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:DALE
Last Name:FERO
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:257 WHISPER RDG
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86301-4211
Mailing Address - Country:US
Mailing Address - Phone:928-445-4960
Mailing Address - Fax:928-776-6125
Practice Address - Street 1:500 HIGHWAY 89
Practice Address - Street 2:MENTAL HEALTH 116
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86313
Practice Address - Country:US
Practice Address - Phone:928-445-4860
Practice Address - Fax:928-776-6125
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3528103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical