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Individual

DR. JAMES NILE WAGLEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
1108 E MARKET ST, CHARLOTTESVILLE, VA 22902-5351
(434) 207-8773
Mailing address
1108 E MARKET ST, CHARLOTTESVILLE, VA 22902-5351
(434) 207-8773

Taxonomy

Speciality
Code
Description
License number
State
103TA0400X
Addiction (Substance Use Disorder) Psychologist
0810004358
VA
103TC0700X
Clinical Psychologist
Primary
0810004358
VA

Other

Enumeration date
06/10/2009
Last updated
08/16/2011
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