Individual
BARRY MICHAEL WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
5225 WISCONSIN AVE NW, SUITE 513, WASHINGTON, DC 20015-2014
(202) 505-1530
(703) 485-4535
Mailing address
5225 WISCONSIN AVE NW, SUITE 513, WASHINGTON, DC 20015-2014
(202) 505-1530
(703) 485-4535
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
0810-002503
VA
103T00000X
Psychologist
Primary
PSY1000762
DC
Other
Enumeration date
07/18/2006
Last updated
07/30/2015
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