LARRY RICHARD WAGNER

COLUMBIA, SC
NPI1659417905
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy103TC1900X Psychologist Counseling
(Licence: SC  657)
Enumeration Date2007-01-30
Last Update Date2007-07-08
Business Address
DR. LARRY RICHARD WAGNER PH.D.
1816 BULL ST
COLUMBIA, SC 29201-2506
Phone number: 803-735-8343
Mailing Address
DR. LARRY RICHARD WAGNER PH.D.
114 GLEN RIDGE CT
IRMO, SC 29063-8494
Phone number: 803-407-3919
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