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Contact Information

JOEL N GLENN WIXSON, PSYD CAS
539 ISLINGTON ST
5
PORTSMOUTH, NH03801
 Phone: 603-427-6858
 Fax: 603-427-6555
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

103TC0700X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for JOEL N GLENN WIXSON · (Male)

NPI # 1174696413
Status Active
Credentials PSYD CAS
Entity Individual
Enumeration date 11/16/2006
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 No
Identifiers
  • NH License # 1056
  • NH Medicaid 304ZO374
  • NH Other 06Y00744INH01 ANTHEM BCBS
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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