Provider Demographics
NPI:1538325246
Name:MANUEL, WADE JOSEPH JR (MA)
Entity Type:Individual
Prefix:MR
First Name:WADE
Middle Name:JOSEPH
Last Name:MANUEL
Suffix:JR
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6750 E STELLA RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85730-2202
Mailing Address - Country:US
Mailing Address - Phone:520-584-5000
Mailing Address - Fax:520-584-5001
Practice Address - Street 1:6750 E STELLA RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85730-2202
Practice Address - Country:US
Practice Address - Phone:520-584-5000
Practice Address - Fax:520-584-5001
Is Sole Proprietor?:No
Enumeration Date:2008-08-01
Last Update Date:2008-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool