Individual
DR. RICHARD A WANTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ED.D.
Contact information
Practice address
1411 N FAIRFIELD RD, BEAVERCREEK, OH 45432-2658
(937) 426-2686
(937) 426-2686
Mailing address
1354 LEMCKE RD, BEAVERCREEK, OH 45434-6727
(937) 657-7655
(937) 775-2042
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
4517
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2000168
—
OH
Enumeration date
07/17/2006
Last updated
07/09/2007
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