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Individual
DR. NATHALIE WAGNER
Active
Individual
DR. NATHALIE WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
018786
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
018786
LICENSE NUMBER
NY
Enumeration date
09/29/2010
Last updated
12/10/2014
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