Individual
DR. ELLEN L. WAGGENER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D
Contact information
Practice address
241 NORTH RD, POUGHKEEPSIE, NY 12601-1154
(845) 431-8872
(845) 485-4113
Mailing address
241 NORTH RD, ST FRANCIS HOSPITAL MENTAL HEALTH CLINIC, POUGHKEEPSIE, NY 12601
(845) 431-8286
(845) 485-4113
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
007671-1
NY
103TC0700X
Clinical Psychologist
007671-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00273845
—
NY
Enumeration date
03/29/2007
Last updated
04/23/2014
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