Individual
DR. JERRY EDWARD WESCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
2235 WHIPPET WAY, SEDONA, AZ 86336-5905
(773) 875-5483
Mailing address
2235 WHIPPET WAY, SEDONA, AZ 86336-5905
(773) 875-5483
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
071-003536
IL
103TC0700X
Clinical Psychologist
Primary
4652
AZ
103TH0100X
Health Service Psychologist
071-003536
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
680014846
MEDICARE RR
IL
Enumeration date
09/15/2005
Last updated
09/22/2015
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