Individual
MR. DAVID A. PRIDDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
575 N KELLOGG ST STE 4, GALESBURG, IL 61401-7609
(309) 343-0800
(309) 343-0802
Mailing address
575 N KELLOGG ST STE 4, GALESBURG, IL 61401-7609
(309) 343-0800
(309) 343-0802
Taxonomy
Speciality
Code
Description
License number
State
103TR0400X
Rehabilitation Psychologist
Primary
071-003839
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
013154
HEALTH ALLIANCE ID
IL
Enumeration date
06/16/2006
Last updated
08/18/2020
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