Individual
RYAN WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSYD.
Contact information
Practice address
4217 SMITH RD, CINCINNATI, OH 45212-4107
(513) 871-7285
Mailing address
4217 SMITH RD, CINCINNATI, OH 45212-4107
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
7466
OH
Other
Enumeration date
01/04/2017
Last updated
01/04/2017
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