Individual
DR. TERRENCE K WAGER
Active
Individual
DR. TERRENCE K WAGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Taxonomy
Speciality
Code
Description
License number
State
103TA0400X
Addiction (Substance Use Disorder) Psychologist
2220
OR
103TB0200X
Cognitive & Behavioral Psychologist
2220
OR
103TC0700X
Clinical Psychologist
Primary
2220
OR
103TC2200X
Clinical Child & Adolescent Psychologist
2220
OR
103TF0000X
Family Psychologist
2220
OR
103TF0200X
Forensic Psychologist
2220
OR
103TP2701X
Group Psychotherapy Psychologist
2220
OR
Other
Enumeration date
08/02/2011
Last updated
05/06/2014
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