| Doctor Name: | DR. AUREEN P. WAGNER |
| NPI Number: | 1023023553 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PH.D. |
| License Number: | NC3973 |
| Business Practice Address: | 2000 Regency Pkwy Ste 204 Cary, NC - 275188507 |
| Business Phone Number: | 9193718230 |
| Business Fax Number: | 9194698639 |
| Mailing Address: | 2000 Regency Pkwy Ste 204, CARY |
| State: | NC |
| Postal Code: | 275188507 |
| Phone Number: | 9193718230 |
| Fax Number: | 9194698639 |
| NPI Enumeration Date: | 07/31/2006 |
| NPI Last Update Date: | 02/25/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC2200X |
| License Number: | NC3973 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NC |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical Child & Adolescent |
| Taxonomy Definition: | |