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Individual

DR. ALISHA LYNN WAGNER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
6750 WEST LOOP S, SUITE 725, BELLAIRE, TX 77401-4103
(713) 854-5400
Mailing address
PO BOX 2273, BELLAIRE, TX 77402-2273
(713) 854-5400

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
31571
TX

Other

Enumeration date
05/28/2014
Last updated
10/31/2014
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