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Individual
SAMUEL ELIAS WAGNER
Active
Individual
SAMUEL ELIAS WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
14236326-3502
UT
1041S0200X
School Social Worker
Primary
—
—
Other
Enumeration date
09/28/2023
Last updated
03/31/2026
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