| Doctor Name: | WADE BRILL |
| NPI Number: | 1033523915 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PSY.D. |
| License Number: | 4969 |
| Business Practice Address: | 1001 Olivesburg Rd Mansfield, OH - 449051228 |
| Business Phone Number: | 4195262100 |
| Business Fax Number: | 4195212822 |
| Mailing Address: | 1001 Olivesburg Rd, MANSFIELD |
| State: | OH |
| Postal Code: | 449051228 |
| Phone Number: | 4195262100 |
| Fax Number: | 4195212822 |
| NPI Enumeration Date: | 06/18/2014 |
| NPI Last Update Date: | 06/19/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TB0200X |
| License Number: | 4969 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | OH |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Cognitive & Behavioral |
| Taxonomy Definition: | |