MARK T WAGNER

CHARLESTON, SC
NPI1346277142
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy103T00000X Psychologist
(Licence: SC  536)
Enumeration Date2006-06-27
Last Update Date2007-07-08
Business Address
-- MARK T WAGNER PHD
171 ASHLEY AVE
CHARLESTON, SC 29425-0001
Phone number: 843-792-1414
Mailing Address
-- MARK T WAGNER PHD
PO BOX 751461
CHARLOTTE, NC 28275-1461
Phone number: 843-792-6200