Individual
DR. ALICIA WAGONER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D
Contact information
Practice address
2675 MEDWAY NEW CARLISLE RD, MEDWAY, OH 45341-9744
(937) 856-7066
Mailing address
2675 MEDWAY NEW CARLISLE RD, MEDWAY, OH 45341-9744
(937) 856-7066
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
8397
OH
Other
Enumeration date
05/11/2018
Last updated
10/27/2023
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