Organization
WAGNER PSYCHOLOGICAL ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK S. WAGNER PH.D. (DIRECTOR)
(215) 331-7707
Entity
Organization
Contact information
Practice address
2824 COTTMAN AVE, SUITE 8, PHILADELPHIA, PA 19149-1400
(215) 331-7707
(215) 331-7790
Mailing address
2824 COTTMAN AVE, SUITE 8, PHILADELPHIA, PA 19149-1400
(215) 331-7707
(215) 331-7790
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PS-003973-L
PA
Other
Enumeration date
04/13/2006
Last updated
08/22/2020
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