Individual
DR. AMY CLAIRE WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D., L.M.F.T.
Contact information
Practice address
104 CENTRAL PARK AVE, WILMETTE, IL 60091-3202
(847) 721-0965
Mailing address
104 CENTRAL PARK AVE, WILMETTE, IL 60091-3202
(847) 721-0965
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071003893
IL
Other
Enumeration date
01/23/2007
Last updated
08/07/2020
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