Individual
DR. CHARLES BRADY DALTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D
Contact information
Practice address
3118 E MARYLAND AVE, PHOENIX, AZ 85016-2377
(602) 909-7539
Mailing address
3118 E MARYLAND AVE, PHOENIX, AZ 85016-2377
(602) 909-7539
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
3660
AZ
103TA0400X
Addiction (Substance Use Disorder) Psychologist
3660
AZ
103TA0700X
Adult Development & Aging Psychologist
3660
AZ
103TC0700X
Clinical Psychologist
Primary
3660
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1073782884
—
AZ
Enumeration date
02/26/2008
Last updated
04/29/2021
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