Individual
DR. ELIZABETH STANTON WAGNER
Active
Individual
DR. ELIZABETH STANTON WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD, MPH
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
LP04105
RI
2084P0800X
Psychiatry Physician
LP04105
RI
2084P0800X
Psychiatry Physician
Primary
MD18427
RI
2084P0804X
Child & Adolescent Psychiatry Physician
LP04105
RI
Other
Enumeration date
06/15/2017
Last updated
08/24/2022
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