Individual
DR. SAMANTHA ANN WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
20747 STERLINGTON DR, LAND O LAKES, FL 34638-4317
(813) 815-2947
(813) 948-0094
Mailing address
20747 STERLINGTON DR, LAND O LAKES, FL 34638-4317
(813) 815-2947
(813) 948-0094
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY11685
FL
Other
Enumeration date
10/26/2022
Last updated
10/26/2022
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