Wagner, Patrick A
Wagner, Patrick A is an sole proprietor health care provider with primary practice located at 8424 Naab Rd Ste 1L , Indianapolis IN 46260-1954. He recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as his primary health care specialty. Wagner, Patrick A can be contacted via phone (317) 338-7780.Contact Information
Primary practice address
8424 Naab Rd Ste 1L
Indianapolis IN 46260-1954
Phone: (317) 338-7780
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X | 20010493A | Indiana |
Profile Details
| NPI number | 1902804446 |
|---|---|
| LBN Legal business name | Wagner, Patrick A |
| Credentials | PHD |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 8th, 2005 |
| Last updated | Sep 8th, 2022 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1902804446 | NPPES |
| Indiana | MEDICAID | 100073410 |
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