Organization
FRED M. SACKS, PH.D. & ASSOCIATES
Active
Other names
Frederick Mark Sacks, Ph.D.
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FRED M SACKS PH.D. (OWNER / PSYCHOLOGIST)
(937) 667-5126
Entity
Organization
Contact information
Practice address
1485 COMMERCE PARK DR, TIPP CITY, OH 45371-2883
(937) 667-5126
(937) 667-7583
Mailing address
1485 COMMERCE PARK DR, TIPP CITY, OH 45371-2883
(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
01
—
12836552300
BWC
OH
Enumeration date
10/18/2012
Last updated
10/18/2012
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