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General NPI Number Information
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NPI Number | 1124016290
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Entity Type | Individual
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Provider Name | MARCIA WARD PHD
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Gender | Female
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Dates
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Enumeration Date | 10/12/2005
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Last Update Date | 06/17/2016
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Provider Practice Location Address
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Address Line | 316 LOUISIANA AVE
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City | PERRYSBURG
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State | OH
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Zip | 43551-1461
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Country | US
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Telephone | 419-874-3212
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Fax | 419-874-3227
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Provider Business Mailing Address
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Address Line | 330 LOUISIANA AVE STE A
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City | PERRYSBURG
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State | OH
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Zip | 43551-1470
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Country | US
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Telephone | 419-874-9488
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Fax | 419-874-4822
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 5761
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License Number State | OH
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