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Individual

DR. STEFANIE G WADE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PSYD

Contact information

Practice address
313 S 3RD ST, GOSHEN, IN 46526-3709
(574) 535-0880
(574) 535-0882
Mailing address
1726 W LINCOLN AVE, STE 2, GOSHEN, IN 46526-5964
(574) 535-0880
(574) 535-0882

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
20042314A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200938090A
IN
Enumeration date
03/29/2007
Last updated
12/04/2019
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