Wayne R Macintosh, MA, LLP
Psychologist, Clinical in Ridgeville, SC. Individual provider (NPI-1).
NPI number1295067973
StatusActive
Last updated in NPPESNov 12, 2015
Details
- NPI
- 1295067973
- Entity type
- Individual (NPI-1)
- Name
- Wayne R Macintosh
- Credential
- MA, LLP
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Feb 5, 2010
- Last updated
- Nov 12, 2015
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103TC0700X | Psychologist, Clinical | 6301010026 | MI | Yes |
Practice location
331 Campbell Thickett RdRidgeville, SC 29472-6339
Phone 843-821-2073
Mailing address
204 Elm Hall CirSummerville, SC 29483-1613
Phone 248-767-6368
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