Individual
DR. KARIN A WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
9 LOCUST RD, BROOKHAVEN, NY 11719-9627
(917) 583-2130
Mailing address
9 LOCUST RD, BROOKHAVEN, NY 11719-9627
(917) 583-2130
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
015920
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P3586132
OXFORD
—
Enumeration date
07/31/2008
Last updated
07/31/2008
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