Provider Demographics
NPI:1770799884
Name:WETCHLER, JOSEPH L (PHD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:L
Last Name:WETCHLER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1247 169TH ST
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:IN
Mailing Address - Zip Code:46324-2003
Mailing Address - Country:US
Mailing Address - Phone:219-989-2587
Mailing Address - Fax:219-989-2027
Practice Address - Street 1:1247 169TH ST
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:IN
Practice Address - Zip Code:46324-2003
Practice Address - Country:US
Practice Address - Phone:219-989-2587
Practice Address - Fax:219-989-2027
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN35000383A106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist