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Individual
DR. NANCY WAGNER-WETZEL
Active
Individual
DR. NANCY WAGNER-WETZEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
7876
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00979424
—
NY
01
—
680408
GHI
NY
Enumeration date
06/13/2006
Last updated
04/19/2012
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