| Doctor Name: | DR. RICHARD GREGORY WIRTZ |
| NPI Number: | 1265548085 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PSY.D. |
| License Number: | 02027 |
| Business Practice Address: | 818 High St Suite 5 Chestertown, MD - 216201152 |
| Business Phone Number: | 4107785550 |
| Business Fax Number: | 4107780984 |
| Mailing Address: | 952 Washington Ave, Suite 5 CHESTERTOWN |
| State: | MD |
| Postal Code: | 216203322 |
| Phone Number: | 4107785550 |
| Fax Number: | 4107780984 |
| NPI Enumeration Date: | 08/22/2006 |
| NPI Last Update Date: | 04/08/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 02027 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MD |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |