Individual
DR. AMANDA WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D., LPC
Contact information
Practice address
49 E MIDLAND AVE, PARAMUS, NJ 07652-2920
(201) 921-0256
Mailing address
PO BOX 184, WALDWICK, NJ 07463-0184
(201) 921-0256
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
37PC00547200
NJ
103TC1900X
Counseling Psychologist
Primary
35SI00692600
NJ
Other
Enumeration date
04/02/2016
Last updated
01/01/2023
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