Individual
MR. FREDERICK MARK SACKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
1485 COMMERCE PARK DRIVE, TIPP CITY, OH 45371
(937) 667-5126
(937) 667-7583
Mailing address
1485 COMMERCE PARK DRIVE, TIPP CITY, OH 45371
(937) 667-5126
(937) 667-7583
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
3768
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0654635
—
OH
Enumeration date
08/04/2006
Last updated
10/18/2012
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