Individual
JULIE A. WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
JOHN DEMPSEY HOSPITAL, 263 FARMINGTON AVENUE, MC-3910, FARMINGTON, CT 06030-0001
(860) 679-4508
Mailing address
JOHN DEMPSEY HOSPITAL, 263 FARMINGTON AVENUE, MC-3910, FARMINGTON, CT 06030-0001
(860) 679-4508
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
002543
CT
Other
Enumeration date
12/28/2006
Last updated
07/08/2007
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