Provider Demographics
NPI:1316699259
Name:SPIEGEL, WAYNE WILLIAM
Entity type:Individual
Prefix:MR
First Name:WAYNE
Middle Name:WILLIAM
Last Name:SPIEGEL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4161 NEWHOUSE RD
Mailing Address - Street 2:
Mailing Address - City:OSTRANDER
Mailing Address - State:OH
Mailing Address - Zip Code:43061-9419
Mailing Address - Country:US
Mailing Address - Phone:740-666-5002
Mailing Address - Fax:
Practice Address - Street 1:4161 NEWHOUSE RD
Practice Address - Street 2:
Practice Address - City:OSTRANDER
Practice Address - State:OH
Practice Address - Zip Code:43061-9419
Practice Address - Country:US
Practice Address - Phone:937-408-5787
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-21
Last Update Date:2022-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services