| John Wagner | |
|
7374 Reading Rd Ste 110 Cincinnati OH 45237-3409 | |
| (937) 620-0542 | |
| (513) 299-0537 |
| Full Name | John Wagner |
|---|---|
| Speciality | Psychologist |
| Location | 7374 Reading Rd Ste 110, Cincinnati, Ohio |
| Authorized Official Name and Position | John Wagner (OWNER) |
| Authorized Official Contact | 9376200542 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| John Wagner 7374 Reading Rd Ste 110 Cincinnati OH 45237-3409 Ph: (937) 620-0542 | John Wagner 7374 Reading Rd Ste 110 Cincinnati OH 45237-3409 Ph: (937) 620-0542 |
| NPI Number | 1609421536 |
|---|---|
| Provider Enumeration Date | 08/07/2019 |
| Last Update Date | 10/19/2021 |
| Certification Date | 10/19/2021 |
| Medicare PECOS PAC ID | 5597156653 |
|---|---|
| Medicare Enrollment ID | O20211228000289 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609421536 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
| Provider Name | John Wagner |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1588719066 PECOS PAC ID: 9133257264 Enrollment ID: I20100512000021 |
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