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Individual
DR. NATHANIEL JACOB WAGNER
Active
Individual
DR. NATHANIEL JACOB WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD, LMHC
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
39003306A
IN
101YM0800X
Mental Health Counselor
MH12360
FL
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
08/21/2012
Last updated
04/15/2025
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