Individual
DR. DAVID P WACKER
Active
Individual
DR. DAVID P WACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Taxonomy
Speciality
Code
Description
License number
State
103TM1800X
Intellectual & Developmental Disabilities Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0459529
—
IA
01
—
P77769
UPIN
IA
Enumeration date
07/17/2008
Last updated
07/17/2008
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