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1962179804
WAGNER PSYCHOTHERAPY LLC
FAIRFAX, VA
NPI
1962179804
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Entity Type
Organization
Authorized Contact
DIANE WAGNER
Owner
703-646-1518
Organization Subpart ?
No
Primary Taxonomy
103TC0700X Psychologist, Clinical
Enumeration Date
2021-08-27
Last Update Date
2021-08-27
Business Address
WAGNER PSYCHOTHERAPY LLC
8280 WILLOW OAKS CORPORATE DRIVE SUITE 600 - #5752
FAIRFAX, VA 22031-4516
Phone number: 703-646-1518
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Mailing Address
WAGNER PSYCHOTHERAPY LLC
10911 ADARE DR
FAIRFAX, VA 22032-3105
Phone number: 703-646-1518
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