Mark Wagner is a Clinical in Sudbury, Massachusetts. Mark Wagner practices all healthcare services and medical treatments related to Clinical. The NPI Number for Mark Wagner is 1780737924. The last update date is 2008-05-01.
Mark Wagner's current location address is 23 Pokonoket Ave, Sudbury, Massachusetts. You can contact this provider via phone number 9784436769. The mailing address for Mark Wagner is 23 Pokonoket Ave, Sudbury, Massachusetts. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Mark Wagner |
|---|---|
| Address | 23 Pokonoket Ave, Sudbury, Massachusetts |
| Phone Number | 9784436769 |
| Fax Number | |
| Sole Proprietor | Y |
| Credentials | PSY.D. |
NPI Number Detail
| NPI Number | 1780737924 |
|---|---|
| Provider Enumeration Date | 2007-01-19 |
| Last Updated Date | 2008-05-01 |
Provider Mailing Address Detail
| Address | 23 Pokonoket Ave |
|---|---|
| City | Sudbury |
| State | Massachusetts (MA) |
| Post Code | 17762320 |
| Phone Number | 9784436769 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 103Tc0700X |
| Licence No | 4472 |
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Definition: A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in |
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What is the unique identification code assigned to Mark Wagner by the Centers for Medicare & Medicaid Services?
The Mark Wagner has been issued the NPI (National Provider Identifier) 1780737924. This 10-digit code serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you share the physical location details of Mark Wagner?
The Mark Wagner is situated at 23 Pokonoket Ave, in the city of Sudbury, state of MA, with the zip code 17762320.
What is Mark Wagner's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for Mark Wagner is Clinical, and the taxonomy classification code that categorizes this area of expertise is 103Tc0700X.
On what date did the Centers for Medicare & Medicaid Services assign the 1780737924 to Mark Wagner?
The Centers for Medicare & Medicaid Services assigned the 1780737924 to Mark Wagner on 2007-01-19.
When was the information regarding Mark Wagner most recently updated?
The details pertaining to the Mark Wagner, including its address, specialty, and other relevant information, were last refreshed on 2008-05-01.