Wax, Alan H

Wax, Alan H is an individual health care provider with primary practice located at 113 Lincolnway E , Mishawaka IN 46544-2016. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Wax, Alan H can be contacted via phone (574) 255-1162.

Contact Information

Primary practice address
113 Lincolnway E Mishawaka IN 46544-2016
Phone: (574) 255-1162
Fax: (574) 255-1882
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X 20040447A Indiana
Behavioral Health & Social Service Providers / Clinical 103TC0700X 20040447A Indiana

Profile Details

NPI number 1851462451
LBN Legal business name Wax, Alan H
Credentials PHD HSPP
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 13th, 2006
Last updated May 31st, 2017 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1851462451 NPPES
Indiana MEDICAID 200021670
Indiana Other 000000368604

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