Organization
DEBORAH WAGNER PHD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEBORAH RISKU WAGNER PHD (PRESIDENT PSYCHOLOGIST)
(201) 445-3299
Entity
Organization
Contact information
Practice address
1172 EAST RIDGEWOOD AVENUE, SUITE #2, RIDGEWOOD, NJ 07450-3928
(201) 445-3299
(201) 262-0425
Mailing address
1172 EAST RIDGEWOOD AVENUE, SUITE #2, RIDGEWOOD, NJ 07450-3928
(201) 445-3299
(201) 262-0425
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
35SI00358200
NJ
Other
Enumeration date
07/02/2007
Last updated
08/22/2020
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