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General NPI Number Information
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NPI Number | 1295819571
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Entity Type | Individual
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Provider Name | WESLEY H WARD PH.D., HSPP
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Gender | Male
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Dates
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Enumeration Date | 10/24/2006
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Last Update Date | 07/26/2010
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Provider Practice Location Address
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Address Line | 3660 ROME DR
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City | LAFAYETTE
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State | IN
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Zip | 47905-4488
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Country | US
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Telephone | 765-446-9394
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Fax | 765-447-8875
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Provider Business Mailing Address
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Address Line | 3124 DOVER LN
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City | LAFAYETTE
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State | IN
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Zip | 47909-6752
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Country | US
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Telephone | 765-742-1816
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Fax | 765-742-2557
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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 | 20040478A
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License Number State | IN
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