Individual
BRENDA J WAGNER
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
5455 MERIDIAN MARK RD NE, STE 400, ATLANTA, GA 30342
(404) 785-3240
(404) 785-3600
Mailing address
5455 MERIDIAN MARK RD NE, STE 400, ATLANTA, GA 30342
(404) 785-3240
(404) 785-3600
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
001706
GA
Other
Enumeration date
05/08/2006
Last updated
07/08/2007
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