| Frederick Mark Sacks, Ph.d. | |
|
1485 Commerce Park Dr Tipp City OH 45371-2883 | |
| (937) 667-5126 | |
| (937) 667-7583 |
| Full Name | Frederick Mark Sacks, Ph.d. |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 1485 Commerce Park Dr, Tipp City, Ohio |
| Authorized Official Name and Position | Fred M Sacks (OWNER / PSYCHOLOGIST) |
| Authorized Official Contact | 9376675126 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Frederick Mark Sacks, Ph.d. 1485 Commerce Park Dr Tipp City OH 45371-2883 Ph: (937) 667-5126 | Frederick Mark Sacks, Ph.d. 1485 Commerce Park Dr Tipp City OH 45371-2883 Ph: (937) 667-5126 |
| NPI Number | 1295088078 |
|---|---|
| Provider Enumeration Date | 10/18/2012 |
| Last Update Date | 10/18/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295088078 | NPI | - | NPPES |
| 0654635 | Medicaid | OH | |
| 12836552300 | Other | OH | BWC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 3768 (Ohio) | Primary |
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