Individual
MR. DALE ALLEN WENKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.A.
Contact information
Practice address
130 N PROSPECT ST, SUITE 12, GRANVILLE, OH 43023-1371
(740) 321-3300
(740) 321-3338
Mailing address
130 N PROSPECT ST, SUITE 12, GRANVILLE, OH 43023-1371
(740) 321-3300
(740) 321-3338
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2034
OH
Other
Enumeration date
05/08/2007
Last updated
07/08/2007
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