Individual
DR. MARILYN R WANDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
3253 N BEND RD, CINCINNATI, OH 45239-7610
(513) 622-9900
(513) 622-9902
Mailing address
3253 N BEND RD, CINCINNATI, OH 45239-7610
(513) 662-9900
(513) 662-9902
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
5564
OH
103TH0100X
Health Service Psychologist
5564
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2267792
—
OH
01
—
45020-0001
CARE SOURCE
OH
01
—
87726
UBH
OH
Enumeration date
02/23/2006
Last updated
08/23/2010
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