Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Marilyn M. Wagner Ph D , PSC

Organization Clinical Neuropsychologist · NPI 1265689475

Marilyn M. Wagner Ph D , PSC is a Clinical Neuropsychologist in Louisville, Kentucky. Licensed in Kentucky. Registered with an NPI since 2008.

Licensed in
KY
In the registry since
2008
What do these letters mean?
PSC — Professional service corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

105A Crescent Ave
Louisville, KY 40206-1525
Phone: (502) 893-4011
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Neuropsychologist (primary) Taxonomy 103G00000X · Licence 0553 (KY)

Record details

NPI number1265689475
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Marilyn Wagner — President · (502) 893-4011
NPI enumeratedAugust 20, 2008
Last updated in NPPESAugust 20, 2008
Mailing address105a Crescent Ave, Louisville, KY 40206-1525

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