| G Lane Wagaman Ed.d. Pllc | |
|
400 Keisler Dr Cary NC 27518-7069 | |
| (919) 803-6393 | |
| (919) 719-0213 |
| Full Name | G Lane Wagaman Ed.d. Pllc |
|---|---|
| Speciality | Psychologist |
| Location | 400 Keisler Dr, Cary, North Carolina |
| Authorized Official Name and Position | G Lane Wagaman (SOLE MEMBER) |
| Authorized Official Contact | 9198036393 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| G Lane Wagaman Ed.d. Pllc Po Box 1424 Apex NC 27502-3424 Ph: (919) 803-6393 | G Lane Wagaman Ed.d. Pllc 400 Keisler Dr Cary NC 27518-7069 Ph: (919) 803-6393 |
| NPI Number | 1588008130 |
|---|---|
| Provider Enumeration Date | 04/25/2013 |
| Last Update Date | 04/25/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588008130 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 1489 (North Carolina) | Primary |
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