Individual
MARVIN WASMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
23230 CHAGRIN BLVD, SUITE 350, BEACHWOOD, OH 44122-5446
(216) 831-2900
(216) 831-4306
Mailing address
23230 CHAGRIN BLVD, SUITE 350, BEACHWOOD, OH 44122-5446
(216) 831-2900
(216) 831-4306
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1002
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000197157
ANTHEM BC & BS
OH
Enumeration date
09/27/2006
Last updated
07/08/2007
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