Blake Douglas Wagner Jr., PH.D.

Psychologist · Mansfield, OH

Individual Active NPI

NPI number 1013069061

Practice location

1575 Marion Ave
Mansfield, OH 44906-3409
Phone
(419) 529-9941
Fax
(419) 529-0496

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NPI record

NPI
1013069061
Entity type
Individual (Type 1)
Enumeration date
January 18, 2007
Last updated
September 2, 2008
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Psychologist Primary 103T00000X I-4127 OH

About Dr. Wagner

Blake Douglas Wagner Jr., PH.D. is a healthcare provider registered in the NPI registry with the primary taxonomy Psychologist (code 103T00000X). The practice location is 1575 Marion Ave, Mansfield, OH 44906-3409. The NPI number 1013069061 was assigned on January 18, 2007 and the record was last updated on September 2, 2008.

Dr. Wagner lists a license in the registry: #I-4127 (OH) for Psychologist. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Blake Douglas Wagner Jr., PH.D.?

The NPI number is 1013069061.

What is the phone number of Dr. Wagner?

The phone number listed for the practice location is (419) 529-9941.

Where is Dr. Wagner located?

1575 Marion Ave, Mansfield, OH 44906-3409.

What is the taxonomy code for Dr. Wagner?

The primary taxonomy code is 103T00000X – Psychologist.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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