Individual
MACY WADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
689 S HIGHWAY 69, PITTSBURG, KS 66762-8600
(620) 412-7475
Mailing address
549 E 600TH AVE, PITTSBURG, KS 66762-8516
(620) 583-0114
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
03183-T
KS
Other
Enumeration date
02/09/2023
Last updated
02/09/2023
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