Organization
WAGONER'S PSYCHOLOGICAL SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALICIA WAGONER PSY.D. (OWNER)
(937) 546-1083
Entity
Organization
Contact information
Practice address
2675 MEDWAY NEW CARLISLE RD, MEDWAY, OH 45341-9744
(937) 856-7066
Mailing address
2675 MEDWAY NEW CARLISLE RD, MEDWAY, OH 45341-9744
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
09/15/2023
Last updated
09/15/2023
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