Individual
DR. ELIZABETH E WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
1 S BROADWAY, SUITE 1-E, WHITE PLAINS, NY 10601-3528
(914) 523-4191
Mailing address
1 S BROADWAY, SUITE 1-E, WHITE PLAINS, NY 10601-3528
(914) 523-4191
Taxonomy
Speciality
Code
Description
License number
State
103TA0400X
Addiction (Substance Use Disorder) Psychologist
014475
NY
103TA0700X
Adult Development & Aging Psychologist
014475
NY
103TB0200X
Cognitive & Behavioral Psychologist
014475
NY
103TC0700X
Clinical Psychologist
Primary
014475
NY
103TC2200X
Clinical Child & Adolescent Psychologist
014475
NY
103TF0000X
Family Psychologist
014475
NY
103TH0004X
Health Psychologist
014475
NY
103TP2701X
Group Psychotherapy Psychologist
014475
NY
Other
Enumeration date
08/28/2007
Last updated
08/28/2007
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