Nicole S. Wagner, Ph.d., Llc

NPI 1053589135 - Psychologist - 103TC0700X

NPI Details
NPI 1053589135
Enumeration Date 02/12/2008
Last Updated 02/12/2008
Entity Type Healthcare Provider
Active Over 8 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
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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.