Individual provider · Type 1 NPI
Blake Douglas Wagner Jr., PhD
Psychologist · Mansfield, OH
Practice location
1575 Marion Ave
Mansfield, OH 44906-3409
Fax (419) 529-0496
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychologist Primary | 103T00000X | I-4127 (OH) |
Psychologist: A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustmen…
4 other providers at this address
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About NPI 1013069061
Blake Douglas Wagner Jr., PhD's National Provider Identifier is 1013069061, issued on Jan 18, 2007. The primary taxonomy on file is Psychologist (103T00000X), and the practice location is in Mansfield, OH. The record was last updated on Sep 2, 2008.