Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. DAVID JAMES DERITA, PHD
Active Sole ProprietorMR. DAVID JAMES DERITA, PHD is a Clinical Psychologist healthcare provider located in TOWER LAKES, Illinois. NPI 1124253547 is currently active in the NPPES registry. Verify at CMS.
Clinical Psychologist · TOWER LAKES, IL
Registration Details
- NPI Number
- 1124253547
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- May 29, 2009 (17.202154518596 yrs)
- Last Updated
- May 29, 2009
- License
-
071-002434 (IL)
- Sole Proprietor
- Yes
Practice Information
- Address
-
215 W LAKE SHORE DRTOWER LAKES, IL, 600101130Browse IL providers · Browse ZIP 60010
- Phone
- 8475266557
- Primary Specialty
-
Clinical Psychologist
103TC0700X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.