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General NPI Number Information
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NPI Number | 1154439248
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Entity Type | Individual
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Provider Name | BARRIE RACHELE WAGNER PSY. D.
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Gender | Female
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Dates
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Enumeration Date | 08/28/2006
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Last Update Date | 05/01/2008
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Provider Practice Location Address
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Address Line | 15849 N 71ST ST STE 100
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City | SCOTTSDALE
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State | AZ
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Zip | 85254-2179
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Country | US
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Telephone | 480-353-2499
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Fax | 602-992-3268
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Provider Business Mailing Address
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Address Line | 15849 N 71ST ST STE 100
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City | SCOTTSDALE
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State | AZ
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Zip | 85254-2179
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Country | US
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Telephone | 480-353-2499
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Fax | 602-992-3268
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 3269
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License Number State | AZ
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