Individual
DR. LAURA ELIZABETH WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
1600 LAKESIDE DR, LYNCHBURG, VA 24501-3116
(434) 316-5000
(434) 316-7071
Mailing address
1600 LAKESIDE DR, LYNCHBURG, VA 24501-3116
(434) 316-5000
(434) 316-7071
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810003438
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
192035
AETNA ID NUMBER
VA
Enumeration date
08/23/2006
Last updated
04/11/2024
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