| NPI Details | |
|---|---|
| NPI | 1053589135 |
| Enumeration Date | 02/12/2008 |
| Last Updated | 02/12/2008 |
| Entity Type | Healthcare Provider |
| Active | Over 9 years ago |
| Authorized Information | |
|---|---|
| Name | NICOLE S NICOLE |
| Position | MANAGING PARTNER |
| Phone | (216) 548-5469 |
| Fax | |
| Practice Location | |
|---|---|
| 11740 CLIFTON BLVD SUITE 202 LAKEWOOD OH, 44107-2057, US |
|
| Phone | (216) 548-5469 |
| Fax | |
| Business Location | |
|---|---|
| 11740 CLIFTON BLVD SUITE 202 LAKEWOOD OH, 44107-2057, US |
|
| Phone | (216) 548-5469 |
| Fax | |
| Toxanomy | |
|---|---|
| Taxonomy Code | 103TC0700X |
| License State | Ohio |
| License Number | 6025 |
| Remove 1053589135 NPI Number | |
According to our database, Nicole S. Wagner, Ph.d., Llc NPI is 1053589135, taxonomy code is 103TC0700X and license number is 6025, license state is located at Ohio. Nicole S. Wagner, Ph.d., Llc physically located at 11740 Clifton Blvd, Lakewood OH, 44107-2057. NPI Number 1033115704 has the healthcare provider type.
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1053589135 NPI number is provided on an as is basis without warranty of any kind. 1053589135 is maintained by the National Plan & Provider Enumeration System. The contents of Nicole S. Wagner, Ph.d., Llc are for informational purposes only.
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