Provider Demographics
NPI:1801000393
Name:DEKAY, JOHANNA WAGNER (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHANNA
Middle Name:WAGNER
Last Name:DEKAY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 12353
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89510-2353
Mailing Address - Country:US
Mailing Address - Phone:775-233-1790
Mailing Address - Fax:775-784-1428
Practice Address - Street 1:401 W 2ND ST
Practice Address - Street 2:SUITE #216 MS354
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89503-5345
Practice Address - Country:US
Practice Address - Phone:775-784-4917
Practice Address - Fax:775-784-1428
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2012-03-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NV140432084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry